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CAST  GOLD  AND  PORCELAIN  INLAYS 


TECHNIC  AND  SCOPE 


OF 


CAST  GOLD  AND  PORCELAIN  INLAYS 


WITH  A  CHAPTEK  OX 

ENDOCRINODONTIA,   OE   THE   DUCTLESS   GLANDS- 
THEIR    EXPRESSION    IX    THE    HUMAN    MOUTH 


BV 
HERAIAX   E.   S.   CHAYKS,  D.D.S. 

NEW  YORK  CITY 


With  372  lUiislrations 


ST.  LOUIS 

C.  V.  MOSBY  COMPANY 

1920 


7^  /"^J  -^ 
(1 


Copyright,  191S,  Br  C.  V.  Mosbt  Company 


Pl'CSS    of 

C.    V.   Mosbij  Coiniiunij 

St.   Louis 


2 

I 

I 


In  My  Firm  Conviction  that  the 
Trials  and  Tribulations  which  Harass 
Us  Are  But  an  E^^DENCE  of  Our  Ulti- 
mate Victory  Over  the  Evils  which  at 
Present  Enslave  Us,  This  Book  Is  Af- 
fectionately  Dedicated    to    jMy    Fel- 

LOWMEN. 


PREFACE 

Tile  introduction  to  this  hook  was  wi-ittcii  in  the  (.ai'ly  ])ai't 
of  1918,  Ix'l'oi-c  the  pcoph'  of  the  worhl  cncii  drcaiiUMl  of  the  tci'- 
rihle  catasti-o))h('  \\hich  has  since  overtaken  thi-ee  continents  and 
tlireatens  to  I'oice  llie  reniainin<2,-  ones  into  the  horrible  and 
voracious  Avliiilpool  of  an  uncivilized  warl'ai-e. 

I  am  includin,!;'  this  introduction  in  S])ite  of  pressure 
h]-ouf;ht  to  bear  u]K)n  me,  because  I  feel  that  a  new  order  of 
tliinf^s  in  "-eneral  is  about  to  appear  in  the  world  and  I  feel  im- 
pelled to  do  what  I  can  to  speed  the  day  of  clearer  thinking, 
greater  tolerance,  and  more  virile  idealism. 

It  holds  somethino-  for  the  man  or  woman  who  will  read  it 
with  the  same  sincere  desire  and  re^^ard  for  truth  and  equity 
and  justice  which  the  author  felt  himself  possessed  of  when  he 
wrote  it. 

I  want  to  at  this  time  pay  my  respects  and  acknowled^-e  my 
obligation  to  the  many  writers  of  the  many  hel])ful  books  I  may 
have  quoted  in  this  volume,  and  express  my  thaid^s  to  the  many 
men  in  my  profession  who  have  labored  and  are  laboring  in  the 
same  or  similar  pursuits,  and  Avhose  work  has  been  helpful  to 
me  to  no  small  degree. 

I  want  to  acknowledge  my  deep  ol)ligations  and  register  a 
jsupil's  sincere  affection  for  my  dear  friend  and  teacher.  Dr. 
Joseph  Fraenkel,  of  Xew  York,  for  the  many  interesting,  help- 
ful, and  clarifying  hours  of  instruction  he  unseltishly  devoted 
to  me  and  to  many  others,  and  which  have  made  me  familiar 
with  a  new,  a  higher,  a  clear,  sane  conception  of  the  physiologic 
and  the  morbid  ])roctsses  which  affect  living  beings  and  things. 

My  thanks  to  my  friend  Dr.  Chas.  G.  Taylor,  an  associate 
of  Dr.  Fraenkel,  for  his  measure  of  helpfulness  in  the  correct 
interpretation  of  the  functions  of  the  endocrines  in  their  asso- 
ciation with  the  dental  a])])aratus.  My  thaidvs  to  Dr.  J.  0.  Lief 
who  kindly  wa(hMl  through  the  entire  inannsci-ijtt  to  foi'nndate 
the  questions  at  the  end  of  each  chapter. 

Manv  thanks  to  all  mv  friends  who  liav(>  stood  l)v  me  and 


10  PEEFACE 

encouraged  me.  To  tlie  officers  and  members  of  the  Chaves 
Dental  Club  whose  loyalty  I  cherish  and  rejoice  in,  whose  ideal- 
ism I  admire  and  ajiprove  of,  and  whose  success  is  my  ardent 
desire. 

Last,  Init  not  least,  I  wish  to  exjjress  my  sincere  aj^pre- 
ciation  and  thanks  to  my  wife  who  has  been  a  source  of  genuine 
inspiration. 

H.  E.  S.  Chayes. 

New  York  City. 


CONTENTS 


CHAPTER     I 

INTRODUCTION 

Soquciicc  of  Thought  and  Its  Value  in  Toaching,  21;  The  Chief  Factors  Induc- 
ing Coordinate  Mental   Efforts,  24;   Some  Rational  and  Acceptable  Conclusions,  48. 

CHAPTER     II 

THE  FUNCTIONS  OF  THE  TEETH 

The   Functions   of   the   Teeth,    52;    Passive   Reciprocal   Functions,   58;    Active 
Reciprocal  Functions,  58. 

CHAPTER     III 

THE  CAST  GOLD  INLAY 

The  Cast  Gold  Inlay,  62. 

CHAPTER     IV 

SELECTION  OR  ELECTION  OF  THE  CASE  PRESENTING 

A  CAVITY 

The  Selection  or  Election  of  tlie  Case  Presenting  a  Cavity,  G4. 
CHAPTER     V 

CAVITY  PREPARATION 

Geometric  Landnuirks  of  Teeth,   65;    Hygienic   Landmarks   of  the  Teeth,   69; 
Cavity  Preparation,  76. 

CHAPTER     VI 

THE  MESIO-DISTO-OCCLUSAL  CAST  GOLD  INLAY 

The   Cast   Gold   Complement   for   a    Tooth   Presenting   a   Mesio-Disto-Occlusal 
Cavity,  120;  Cavity  Preparation,  121. 

CHAPTER     VII 

THE  SELECTION  OF  THE  PROPER  WAX 

The  Selection  of  the  Proper  Wax,  127. 

n 


12  C(1NTKNTS 

C  I  r  A  P  T  E  R     Y  1 1 1 

:\IAKl\(i  AND  CARVINCt  OF  THE  AVAX  INLAY  BY  THE  USE  OF 
THE  DIEET'T  METHOD 

Making  aiul  Carving  uf  tlio  Wax  Inlay  by  the  Use  of  the  ]>iieet  MetlioJ,  131. 
C  H  A  P  T  E  R     IX 

TAKING  AN  IMPRESSION  OF  THE  CAVITY  AND  MAKING   A 
DIE  FOR  PROCEDURE  BY  THE  INDIRECT  METHOD 

Taking  an  Impression  of  the  Cavity  and  Making  a  Die  for  Piocedurc  by  tlic 
Indirect  Method,  139;  The  Making  of  the  Amalgam  Die,  148. 

C  II  A  P  T  E  R     X 

THE  INVESTMENT,  OR  REFRACTORY,  COMPOUND 

The   Investment,   or  Refractory,   Conipound,   158;    Silicon,    IGO;    Calcium,   1G2; 
Magnesium,  162;  Alumina,  163. 

CHAPTER     XI 

THE  DRYING  OUT  OF  THE  MOLD  AND  THE  B1TRNL\(!  Ol  T  OF 

THE  WAX  :\IODEL 

Tlio   Drying  Out  of  tiie   Mold  and  tiic   Burning  Out  of  the   Wax  Model,   173. 

CHAPTER     XII 
THE  (AST1N(!   ol-'  TIIL  MOLTEN  ,MLTAL   INTO  'VWK   .MOLD 

The  Casting  of  the  :Moitcii  Metal  into  the  Mold,  178. 

CHAPTER     XIII 

THE  METALS  FOK  TIIL   I.\LA^'  WOIJKLIJ 
Til.;  Metals  for  the  Iiday  AVorkci,  ls2. 

C  H  A  L'  T  E  R     X  I  V 

TiiL  (AsTLXo  OI-'  'II II';  .M(>i/n;.\  mi:  tal  i.\t<>  tin-;  .mold  .\.\d 

A    CONSIDI^ILVTIO.X    OF  TIIL    \'.\IGo|  S    M  .\(   I II X  LS 

L.Ml'l>o^■|•:l) 

The  Casting  of   tlie   M(.lt<-n    Metal    into   thf   .Mold    and   a  Consideration    of   the 
Various  Machines  Eini)loyed,  187. 


CO  NTi:  NTS  13 

C  TT  AFTER     X  V 

THE  CLEANSING  OF  THH  CASTING  IN  nVDKOFLTTJRIC  AGTD 
AND  IN  A  SODH'M  BIGAKBONATK   I5ATII 

T1h>  Clcjuisiiin'   of   tlio   Casting'   in    llyilrofiudric    Acid    ami   in   a   Sodiuni   Biear- 
Ixinate  I'.atli,  lidO. 

C  H  A  P  T  1']  R     X  Y  I 

KKAFOVAL  OF  THE  ENCESS  OF  METAL,  THE  POLISHING,  AND 
THE  ('FOMENTATION  OF  THE  INLAY 

Removal  of  the  Excess  of  Metal,  tlie  Polishing,   and  the  Cementation   of  tlio 
Inlay,  213. 

C  H  A  P  T  E  R     X  V  1 1 

THE  SPLINTING  OF  LOOSE  TEETH  BY  MEANS  OF  INLAYS 

The  Splinting  of  Loose  Teeth  by  Means  of  Inlays,  218. 
CHAPTER     X^^III 

EXTENSIVE  RESTORATIONS  OF  OCCLUSAL  BALANCE  BY 
MEANS  OF  GOLD  INLAYS 

Extensive   Restorations   of   Occlusal   Balance   by   Means   of   Gold   Inlays,   236; 
Construction  of  the  Splint,  245. 

CHAPTER     XIX 

GOLD  INLAYS  AND  THE  SILICATES  OR  PORCELAIN 

Gold  Inlays  and  the  Silicates  or  Porcelain,  2G9. 

CHAPTER     XX 

THE  PHENOMENA  OF  LIGHT  AND  COLOR 

The  Phenomena  of  Light  and  Color,  302;   Reflection  and  Refraction  and  Ab- 
sorption, 304. 

CHAPTER     XXI 

THE  PORCELAIN  INLAY 

The  Porcelain  Inlay,  322;   Cavity  Preparation,  328. 
CHAPTERXXII 

ENDOCRINODONTIA,  OR  THE  DUCTLESS  GLANDS— THEIR 
EXPRESSION  IN  THE  HUMAN  MOUTH 

Endocrinodontia,    or    the    Ductless    Glands — Their    Expression    in    the    Human 
Mouth,  359. 


ILLUSTRATIONS 


FIG.  PAGE 

1.  Diagram    slio\vin<;'   rccipiocal    functions    of   the   tooth 59 

2.  Showing  diagiammatically  the  various  surfaoos,  lino  an^los,  and  cutting,  or 

point,    angles    of    incisor    teeth 06 

3.  Showing  diagrammatically  the  surfaces,  line   angles,  and  cutting,  or  point, 

angles    of    a    cuspid G6 

4.  Showing  diagrammatically  surfaces,  line  angles,  and  point  angles  of  bicus- 

pids   and    molars 66 

5.  Immune  areas  of  anterior  teeth  and  susceptible  areas 70 

6.  Immune  areas  of  posterior  teeth ...      70 

7.  Immune  areas  and  susceptible  areas  of  posterior  teeth 70 

8.  A  set  of  chisels  used  by  the  author  in  tooth  structure  cutting 72 

9.  Cross  section  of  molar  tooth  illustrating  prepared  cavity  and  bevel      ...      74 

10.  Cross  section  of  molar  showing  a  disto-occlusal  cavity 74 

11.  Longitudinal  section  of  molar,  showing  mesial  and  distal  planes     ....      78 

12.  Cross   section   of   bicuspid 78 

13-17.  Five  views  of  an  upper  first  bicuspid  presenting  a  simple  occlusal  cavity, 

and  the  east  gold  inlay  made  for  it .80 

18-24.  Seven  views  of  a  first  right  lower  bicuspid  presenting  a  compound  disto- 
occlusal  cavity  involving  also  the  cervical  portion  of  the  buccal  wall, 
restored  with  a  cast  gold  inlay  disto-occlusally,  and  a  porcelain  inlay 
buccally 82 

25-32.  Eight  views  of  an  upper  first  bicuspid  presenting  a  mesio-occlusal  cavity, 

and  the  restoration  made  for  it 84 

33-37.  Five  views  of  a  lower  second  bicuspid  presenting  a  mesio-disto-occlusal 

cavity,  and  the  inlay  made  for  it 86 

38-46.  Nine   views   of    a   mesio-occlusal    cavity   in    a    first    lower   bicuspid,    and 

restoration   made    for   it 88 

47-54.  Eight  views  of  a  lower  second  bicuspid  presenting  a  mesio-disto-occlusal 

cavitj',  and  the  restoration  made  for  it 90 

55-60.  A  first  lower  molar  presenting  a  labio-  or  bucco-occlusal  cavity,  and  the 

cast  gold  inlay  made  for  it 92 

61-68.  A  lower  molar  presenting  a  disto-occlusal  cavity,  the  lower  half  of  the 

buccal  wall  being  involved  to  the  full  mesial-distal  extent     ....     94 

69-78.  A  disto-occlusal  cavity  in  an  upper  molar  and  a  disto-buccal  cavity  in  the 
same  tooth.  Two  cast  gold  inlays  for  the  respective  cavities  and  three 
views  of  the  finished  operations 96 

79-86.  A  mesio-disto-occlusal  cavity  in  an  upper  molar,  also  a  buccal  cavity  in 

the  same  tooth 98 

87-88.  Two  illustrations  of  teeth  worn  down  by  attrition,  restored  by  means  of 

the  cast  gold  inlay,  imitating  the  conditions  of  adjacent  teeth     .      .      100 

89-94.  Left  first  lower  molar  presenting  deficiency  of  occlusal  third.  Views 
illustrating  preparation  of  cavity  and  restoration  made  for  it  in  the 
shape  of  a  cast  gold  inlay 102 

15 


16  ILLVSTItATlOXS 

FIG.  PAGE 

!'.j-]"2.  A    coinplcx    finity    in    an    u]i]i('r    niolav    invnlvin;;'    i'vovy    surface    of 

the    tooth,   and    cast   gold    inlay    made    for    it 104 

103-111.  Nine  views  of  a  second  lower  niohir  presenting  a  niesio-disto-oc- 
clusaidinccal  ca\ity  and  two  interlocking  cast  gold  inlays  made 
for     it IOC. 

112-119.  A    mesio-occlusal-palatal     caxity    in    an    iqipcr    molar    restored    by 

means    of    a    cast    gold    inlay lOS 

12U-li!7.  Eight   views   of   a   nicsio-disto-occlnsal    cavity    in    an    u]ii)('i-   second   lii- 

ciisi>id,  and  the  cast  gold  inlay  ma<le  for  it 110 

128-l.j-j.  Eight  views  of  a  complex  cavity  in  an  upper  second  bicuspid,  and 
the  restoration  made  for  it  in  the  shaj)e  of  a  cast  gold  inlay.  The 
labial  portion  of  this  inlay  lias  Ijeen,  in  turn,  inlayed  with  synthetic 
porcelain 112 

136.  Stress  index  for   upper  teeth 11-1 

137.  Stress   index    for   lower   teeth 115 

138-139.  Buccal  and  lingual  views  of  a  case  of  nearly  normal  occlusion      .      117 
140.  The  first  cut  after  the  decay  has  been  removed  in  the  preparation  of  a 

niesio-occlusal-distal   cavity  in  a  nujlar 122 

111.   Tlie    ,«econd    cut,    renio\al    of    the    mesial    wall,    to    jnovide    for    the    onlay 

part  of  the  inlay      ....  122 

142.  The  third  cut.     The  i-enio\al  of  tlie  distal  wall  to  provide  for  the  onlay 

part     of    the     inlay 12."> 

143.  Tiie  final  cut.     The  l)evel  u]ion  the  occlusal  surface  continuous  with  the 

niesio-buccal,     disto-buccal,     mesio-lingual,     and     disto-lingual     guides 

of  the  cavity,  which  guides  arc  beveled  outward 123 

144.  The  wax  inlay  made  for  the  mesio-occluso-distal  ca\ity 124 

14."3.  The  fini.shed  inlay  in  position  upon  the  tooth 124 

14(i.  Tiie     Taggart     automatic    wax    warmer 132 

147.  A  glass  of  water  with  cork  and  pins  for  submerging  wax      ....      134 

148.  A  spatula,  a  set  of  right  and  left  and  straight  flat    htirnisliers.   lancets, 

right    and    left    carvers,  and    hand    drills 137 

149.  Method    of  making  a   handy  matrix 141 

].">0.  Illustrating  a  liandy  matrix  in  position   upon   a   molar 141 

1;j1-1.j2.  Hinged  traj's  for  taking  correct  impressions  of  mcsio-disto-occlusal 

cavities   and   teeth    npo?!    whieh    they    pi-esent 144 

l.")3.  JJisto-occlusal    cavity    tray 144 

1.54.  Mesio-occlusal   cavity   tray 144 

l.l.j.  Hinged    tray    for    anterior    ti'cth 14  1 

1~}G.  Hinged    traj'    in     position 1  I." 

157.  Hinged    tray    in    closed    position 11") 

158.  Complete   impression    of  tooth   and    cavity    emliedijeil    in    jijastei'   impics- 

sion  of  adjacent    teeth,  ready   for  the   paeking  oC  anial^ani   die      .       .  117 

159.  Complete  iirii)ression   of  tooth  and   cavity,  remove<!    from    (Ik;   mouth      .  117 
1*50.   Model   presenting  a  view   of  amalgam   replica   of   tootli    i((|iiiring  restora- 
tion in  correct  relation  to  adjai-ent  teeth l."i(i 

I'jl.  Model  lubricated  with  mixture  of  castor  oil  and  glycerine      ....      150 

]G2.  Occluded    models    of    case    requiring    restoration 151 

103.  The  Taggart  automatic  investment  mixer  attached  to  a  lathe     .      .      .      108 


ILLUSTRATIONS  17 

FIC;.  PAGE 

1()4.  TliG'  Taggart  automatic  investment  mixer  attached  to  its  own  motor,  a 
clock  with  an   alarm   which  rings  when  the  compound   is  ready  for 

use 168 

163.  Tile  Taggart  mixer  as  used  in  tlic  autiior's  laboratory 170 

166.  Taggart  automatic   (gas)   burner  for  removing  wax  pattern  from  mold  174 

167.  Platcheck  furnace  closed,  .showing  flue,   or  chimney 175 

1()8.  The  platcheck  furnace  for  Ijurning  out   the  wax 176 

169.  The  charcoal  block  with  a  depression  in  it   to  act  as  a  crucible      .      .  183 

170A.  The  Elgin  va(-uum  casting  machine  and  flasks 192 

170J5.  Same  machine  as  in  Fig.  170.4,  ready  for  casting 192 

171.  Taggart  machine  with  flask  in  position  on  its  base 201 

172.  The  Taggart  machine  raised  to  permit  the  use  of  a  nundier  of  sizes  of 

larger     flasks      202 

17;].  To  the  right  is  a  view  of  a  small  Taggart  flask  and  its  crucible  former 

\vhich    holds    the    sprue    wire 204 

174.  A  special  flask,  barrel-shaped 204 

17.J.  Acid  cuji,  support,   and  stopper   for   liydrotluoric   acid 210 

176.  Showing  the  parallelometer  wrench  in  position  on  locking  stud      .      .      .  219 

177.  Measuring    posts    on    parallelometer    in    position    for    all    measurements 

from   6   mm.   up   to   and  including   10   mm 219 

17>i.  Measuring  posts  in  same  clamps  as  in  preceding  cut,  but  with  the  dis- 
tance between  them  increased  to   10  mm 220 

179.  Showing  position  of  measuring  posts  for  all  measurements  from  10  mm. 

up   to   and   including   25   mm 220 

180.  Measuring   posts   in    same   clamps   as   in   Fig.    179,    Imt    with    the   distance 

increased     to    40     mm 221 

181.  When  the  distance  to  be  measured  exceeds  40  mm.,  the  parallelometer  is 

reversed  and  the  measuring  posts  are  placed   in  the  clamps  as  shown  221 

182.  Measuring  posts   in   same   clamjis   as   in   Fig.    181,    but    the   distance   has 

been  increased  to  55  mm 222 

183.  The  above  cut  shows  where  the  parallelodrill  should  be  oiled     .      .      .  223 

184.  Distance    established    between    cuspids 224 

185.  Showing  the  operation   of  the  parallelodrill  reaming  out   two   root   canals 

in     the     two     upper    cuspids    to     receive     the     split    pin     and     tube 

attachments 224 

186.  Showing  the  method  of  transferring  the  distance  from  the  parallelom- 

eter   to    the    parallelodrill 226 

187.  Distance    established    between    cuspid    and    lateral    on    opposite    side    of 

the     arch 228 

188.  Distance  established   between   right  cuspid  and  left  lateral      ....  228 

189.  Distance  established  between  left  cuspid  and  right  central      .      .      .  230 

190.  Distance  established  between  right  cuspid  and  left  central      ....  230 

191.  Finished   splint   ready  to   be  inserted 232 

192.  A  case  of  extensive  restoration 237 

193.  A  view  of  a  splint  made  for  a  case  of  extensive  restoration      ....  247 

194.  Another  view  of  the  splint  shown  in  Fig.   193,   which,  when  it  was  first 

made  and  worn,  covered  all  the  anterior  portion  of  the  jaw,  as  well 

as  the   part   now  occupied   l)y   it 247 


18  ILLUSTEATI02TS 

FIG.  PAGE 

195.  The  splint  in  position  on  the  model 247 

196.  An   occlusal   view   of   the   models   of   a    ease,   showing   the   terrible   havoc 

wrought  by  neglect 252 

197.  The  model  of  the  upper  teeth  of  case  after  six  months'  treatment      .     252 

198.  The  lower  model  model  showing  clearly  the  rebuilding  of  the  anterior,  and 

some  of  the  posterior,  teeth  by  means  of  the  cast  gold  inlay  and 
cast     base     crowns 252 

199.  The  upper  and  lower  models  in   occlusion 252 

200.  An  occlusal  view  of  a  finished  case  of  extensive  restoration  by  means  of 

cast    gold   inlays   and   two    upper    bridges 254 

201.  A  side  view  of  the  same  case — upi^er  and  lower  models  in  occlusion     .  254 

202.  Diagram   of   face    showing   normal   proportions 255 

20.3.  Chart    showing    geometrical    construction    of    crown 256 

204.  Illustrating   determination    of   proximal   contact   between   molars     .      .      258 

205.  (1)   A  horizontal  section  representing  the  occlusal  plane  of  the  middle 

third  of  an  up^jer  second  bicuspid.  (2)  A  horizontal  section  repre- 
senting the  occlusal  plane  of  the  middle  third  of  a  lower  second 
bicuspid 259 

200.  Showing  how  perfectly  occlusal  surfaces  may  be  carved  in  the  wax  and 

reproduced  by  means  of  the  casting  process 260 

207-209.  Three   illustrations  of  beautiful   occlusal   surfaces 263 

210.  Xote  the  two  illustrations  on  the  lower  i)ortion  to  the  left,  with  their 

inefficient  occlusal  surfaces,  and  compare  the  four  other  illustra- 
tions with  their  definite  sulci  eusps,  and  fissures 264 

211.  Showing    the     ways     in     which     attrition     manifests     itself     in     different 

types 265 

212.  Another  type  of  the  result  of  attrition 265 

213-218.  A  case  of  extensive  restoration 267 

219-225.  Gold  inlays  and  porcelain  or  the  silicates.     A  number  of  views  of  a 

lower    central    fractured    in    a    fall 270 

226-232.  A  number  of  views  of  a  lower  lateral  restored  by  means  of  a  cast 

gold   inlay   and   synthetic   porcelain 272 

233-239.  A  number  of  views  of  a  lower  lateral  involved  by  fracture  and 
decay  restored  liv  tlio  use  of  a  gold  inlay  in  conjunction  witli 
silicate     cement — root     filli-d 274 

240-246.  A  number  of  views  of  a  U>wvy  lateral  friuturcd  in  a  fall.  Extir- 
pated      pulp 278 

247-253.  Seven  views  of  a  lower  cuspid,  presenting  another  type  or  restora- 
tion, also  a  combination  cast  gold  inlay  and  porcelain  insert      .      .      .      280 

2.54r260.  Seven  views  of  a  broken-down  cusjiid  restor('(l  with  a  cast  gold  in- 
lay and  a  porcelain  insert 282 

201-267.  A  left  upper  lateral  presenting  a  mesio  Inbin  iingno-incisal  d((fi- 
ciency  restored  to  use  and  cosmetic  .'icf'c|jtaMcncss  by  a  cast  gold 
inlay    and     synthetic     porcelain 284 

268-275.  View.s  of  a  right  upper  central  presenting  a  large  mesio-labio-linguo- 
inci.sal  djcficiency,  restored  to  use  annd  cosmetic  acceptableness  by 
a  cast  gold  inlay  and  porcelain  insert 288 


ll.LlIS'rilATfON.S  19 

FIG.  PAGE 

276-282.  Views  of  a  left  upper  central  presenting  a  mesio-disto-labio-iucisal 
deficiency,   restored   to   use   and   cosmetic   nccoptablcncss   by  a  cast 

gold  inlay  and   synthetic   porcelain   insert 290 

2S;!-28i).  A   nunil)er   of   views   of   a   right  upper   central   pres^eiiting    an   eroded 
and  pitted  labial  surface,   a  niesio-  and  disto-proximal   cavity,   and  a 

lingual  enamel  surface  which  was  perfect,  as  was  the  incisal  eilgc  292 

290-296.  Seven  views  of  another  type  of  restoration  in  an  upper  cuspid      .      .  296 
297-303.  Seven    views    of    a    right    upper    (■us])i(l    ]ir('sciiting    a    prehenso-labio- 

linguo-uiesial      deficiency 298 

304.  Diagram    showing    refraction    of    light 307 

30;").  Color      chart 316 

306.  Method  of  obtaining  a  separation  between  two  teeth  which  are  to  be 

inlayed 330 

307.  Method   of  separating  two  teeth  that  lean  towards  one  another      .      .  331 

308.  Manner  of  preparation  of  a  simple  cavity  for  a  porcelain  inlay      .      .  332 
309-311.  Foil  between  two  layers  of  goldbeater's  skin 333 

312.  A  set  of  eight  glass  burnishers  used  in  adapting  a  foil  matrix  to  the 

cavity  in  a  tooth  or  in  a  die 334 

313.  A    set    of    tantalum    instruments 334 

314.  A   small   platinum  tray 334 

315-318.  The  mixing  of  the  silver  amalgam 335 

319.  Foil  reposing  between  the  layers  of  goldbeater's  skin  and  the  applica- 

tion  of   the   hand    swager 336 

320.  A  disto-labial  ca\'ity  in  a  central 338 

321.  A  strip  of  x>latinoid  bent  at  an  obtuse  angle  and  perforated  so  as  to 

hold   the    compound    which    is    softened    in    the    flame    and    deposited 

upon  the  improvised  tray 338 

322.  Carrying    tray    and    compound    between    the    teeth    and    forcing    the    ma- 

terial   into    the    cavity 338 

323.  Lingual   view   showing   surplus    of    compound 338 

324.  Flat  straight  spatula  to  aid  in  placing  and  holding  impression  material  338 

325.  A  labio-disto-lingiial  cavity  in  a   lateral 339 

326.  First   step   in   formation    of   tray 339 

327.  Second   piece   of   metal 339 

328.  Improvised  slide  made  from  metal   shown   in  Fig.   327  to  fit   into  that 

shown    in    Fig.    326 339 

329.  Showing     completed     slide 339 

330.  Slide    carrying    compound    and    taking    impression    of    lingual    part    of 

cavity  and  all  of  distal  part 339 

331.  Slide  is  raised  and  the  impression  is   removed  from   tiie   tooth  in   a  lin- 

gual    direction 339 

332.  A   linguo-mesial    cavity    in    a    lateral 340 

333.  The     tray 340 

334.  The      impression 340 

335.  The   plastic   instruments   used    as   an    aid   to    project   the   compound   into 

the  cavity 340 

336-338.  Showing   cervical    cavity   in    a    cuspid,    the    partly   and   completely 

formed    tray 340 


20  ]llustj;atioxs 

FIG.  PAGE 

339-341.  A  cervical  proximal  in  a  lateral  and  the  partly  and  the  com- 
pletely formed  trav  for  taking  impression 341 

342-346.  A  cervical  cavity  in  the  disto-labial  surface  of  a  molar,  the  partly 
and  the  completely  formed  tray  with  compound  in  position  on  the 
tooth,  and  the  impression   of  tlic  cavity 341 

347-351.  Same  as  shown  in  Figs.  340  to  349  on  opj)ositc  side  of  the  arcli      .      342 

.■>32-3j4.  a   disto-occlusal   cavity  in  an  upper   molar,   tlio  partly   and  the  coin- 

jiletely  formed  tray 342 

345-357.  A  labio-occlusal  cavity  in  a  molar,  the  imrtly  and  the  completely 

formed     tray 342 

358-360.  Another  type  of  disto-occlusal  cavity  in  a  molar,  the  i^artly  and  the 

completely    formed    tray    for    taking   impression 342 

361-362.  A    mesio-occlusal    cavity    in    a    lowar   molar    and    traj''    for    taking 

impression  343 

363-366.  A  mesio-disto-occlusal  cavity  in  a  molar,  partly  and  completely 
formed  tray  for  carrying  the  compound  to  take  impression  of  this 
cavity 343 

367-370.  M.  O.  D.  cavity  in  bicuspid,  partly  and  completely  formed  tray  for 

taking     impression 344 

371.  A  handle  and  set  of  trays,  or   cups,  which   may  be   trimmed  to  suit   the 

case  to  facilitate  the  taking  of  impressions  of  various  cavities      .      .      344 

372.  The    Protector    of    David 378 


CAST  GOLD  AND  PORCELAIN  INLAYS 


CHAPTER  I 

ixTiJoDrcrriox 

SEQUENCE  OF  THOUGHT  AND  ITS  VALUE  IN 
TEACHING 

U.sefiiliiesf<,  in  the  broad  sense  of  the  word,  determines  the 
value  of  man  to  mankind.  Usefiihiess  is  tlie  purpose  of  this 
Yohime.  To  help,  to  improve,  to  simplify,  to  make  clear  obscure- 
problems  in  tliis  particular  field,  will  mean  a  better  equipped 
I^rofession,  and  hence  must  mean  betterment  to  the  great  human 
family  depending-  ujion  our  profession  for  their  comfort  and 
health. 

The  ambition  to  determine  definitely  foi'  the  profession  the 
best  mode  of  procedure  in  this  work,  to  coherently  elucidate 
innumerable  points  much  discussed  and  poorly  understood,  to 
delve  into  all  crevices  of  the  task,  to  throw  the  ray  of  sane, 
investigating  reason  into  tlie  shadows  of  the  recesses,  to  at- 
tempt and  succeed  in  proving  all  statements,  to  evade  noth- 
ing,— a  task  to  be  reckoned  with  ])ut  worthy  of  the  best  efforts. 

To  best  serve  its  purpose,  this  volume  must  be  both  ele- 
mentary and  postgraduate,  and  no  apology  is  offered  if,  at  the 
beginning,  it  may  appear  to  the  student  that  he  is  reading  some- 
thing he  already  knows.  In  fact  it  is  l)est  to  make  it  Y)\i\in  now, 
that  in  order  to  be  truly  useful,  and  readily  comprehended, 
teaching  must  always  l)egi]i  with  something  already  well  estab- 
lished in  the  student's  mind. 

In  attempting  to  teach  a  body  of  students  or  a  single  stu- 
dent anything  their  or  his  knowledge  of  which  is  deficient,  it 
is  conducive  to  best  understanding  to  start  at  first  principles. 

To  be  efficient,  a  text])ook  nnist  l)e  so  written,  and  par- 
ticularly so  begun,  that  the  first  thing  to  greet  the  student 

21 


22  CAST    GOLD    AXl)    POltCELAlN    INLAYS 

iiiiiid  is  a  statement  of  a  fact,  or  a  fact,  already  lixedly  estab- 
lished in  liis  mind;  and  from  that  lone  hut  well-estahlished  fact, 
all  avenues  of  research  and  investigation  and  proof  must  issue, 
to  converge  again  at  and  upon  a  perfectly  logical  and  hence 
well  dovetailed  conclusion.  Thus  it  is  seen  that  sequence  in  a 
textbook  plays  a  great  part  in  determining  how  valuable  the 
book  is  to  i^rove  to  the  student. 

AVe  must  have  then,  a  well-known  fact,  a  universally  known 
fact,  so  far  as  our  profession  is  concerned,  and  proper  sequence 
as  we  go  along;  and  we  must,  after  diverging  with  proper 
sequence  and  reaching  into  every  cranny  of  the  process,  so  con- 
^■erge  our  thoughts  that  only  one,  and  that  the  proper  conclu- 
sion, is  possible. 

The  foregoing  qualities  will  make  up  a  useful  and  neces- 
sary textbook.  It  is  easy  for  the  student  to  prove  the  real 
value  of  this  book  to  himself  by  carefulh^  reading  it  from  the 
beginning,  and  if  he  reaches  his  conclusions  before  he  finishes 
the  last  chapter,  and  if  his  conclusions  coincide  with  the  con- 
clusions of  the  book,  then  the  correctness  of  its  logic  is  proved, 
and  its  value  as  a  textbook  becomes  apparent. 

If  I  were  to  attemj^t  to  teach  the  science  of  cooking,  I 
should  begin  my  textbook's  first  chapter  with  the  statement 
that  food  is  absolutely  essential  for  the  maintenance  of  the 
various  functions  that  make  up  the  activities  of  mankind,  and 
the  animal  as  well  as  the  vegetable  kingdoms.  That  would  be 
stating  a  fact  already  well  established  in  the  student's  mind, — 
so  fixedly  estal)lished  that  no  amount  of  argument  could  dis- 
lodge it.  From  tliat  lone  fact,  I  could  send  out  mental  expedi- 
tions of  investigation  into  every  phase  of  the  question,  covering- 
food  as  to  kinds,  quantity  and  quality,  necessity  and  luxury; 
food  for  man,  for  animal,  and  for  vegetable:  and  we  could, 
after  discussing  all  of  Ihcni,  llicii'  origii;  and  pi'cpai'ation,  and 
reasons  thereof,  tlieir  coinijai-ative  values  and  reasons  there- 
for, so  converge  my  (iiidiiigs  as  to  veiy  propeily  feel  that  the 
very  best  thought  with  which  to  end  the  l)ook  would  be  the  food 
thought. 

AVere  I  to  attemj)t  a  work  on  aichitcclurc,  docs  it  not  seem 
to  you,  the  n('o])liytc,  the   iininil  ialcd,  tlial    i1    would   lie  best  to 


SEQUENCE    OF    TfKKTGlIT  23 

start  at  tlie  vei-y  begiiiiiiii*;'  of  tilings  and  slate  a  fact  already 
fixedly  established  in  your  neojjliytic  mind  t  Sui)pose  then, 
1  were  to  say  that  man  is  poorer  than  animal  in  brnte  force, 
and  richer  than  the  animal  in  intellect;  and  that  even  preliistoric 
man  had  a  cave  to  live  in,  to  house  liiiii  and  Ids  descendants: 
that  would  be  stating-  a  simi)le  and  true  fact,  already  well  estab- 
lished in  the  student's  mind  (in  any  mind  for  that  matter),  and 
how  easy  it  would  be  to  logically  follow  up  that  simple  state- 
ment of  fact  and  show  comprehensively  that  that  cave  or  dwell- 
ing varied  in  size  with  the  requirements  of  the  human  numer- 
ically, and  that  it  varied  in  kind  Avith  the  requirements  of  the 
human  geographically. 

Could  I  not  very  naturally  go  on  to  show  how,  with  the 
evolution  of  man  from  preliistoric  tyjje  to  complexly  civilized 
variety,  desires,  requirements  and  habits  changed  and  brought 
on  housings  as  different  from  the  prehistoric  cave  in  appear- 
ance and  in  service  as,  let  us  say,  Gladstone  differed  in  type  and 
mentality  from  prehistoric  man? 

So  may  I  not  very  simply,  and  very  truthfully,  and  witli 
clarifying  and  illuminating  sequence,  go  to  the  next  statement 
which  tells  us  that  with  the  great  increase  in  the  human  species, 
came  the  emigration  of  tribes  into  various  corners  of  the  globe, 
and  that  their  various  requirements  in  the  direction  of  being 
properly  housed,  were  influenced  as  before  by  geographic  and 
geologic  conditions  ?  Perhaj^s  too,  in  their  travels  to  their  new 
locality,  they  had  imbibed  some  of  the  beauty  of  Nature's  vast 
architecture,  and  had  become  desirous  of  injecting  part  of  it 
into  their  own  handiwork.  This  seems  very  reasonable,  and  so 
one  can  go  on  and  readily  proceed  to  show  how  the  architecture 
of  today  originated,  how  it  grew  and  developed  into  its  apparent 
complexity,  but  in  reality  into  its  scientific  simj)licity.  I  can 
trace  them  all,  the  Greek,  the  Roman,  the  Ionic,  the  Renaissance, 
etc.,  and  can,  after  tracing  them  all  with  proper  sequence  and 
perfect  logic,  so  converge  my  findings  as  to  very  pro23erly  feel 
that  the  very  best  thought  with  wliich  to  close  tlie  book  on  archi- 
tecture would  be  the  thought  that  the  human  is  poorer  than  the 
animal  in  brute  force,  but  richer  than  the  animal  in  intellect. 
So,  in  the  beginning,  for  his  own  preservation  and  prote'Ction, 


24  CAST    GOLD    AXD    POKCELAIX    INLAYS 

and  for  the  i)i'otection  and  preservation  of  liis  species,  lie  built 
himself  a  cave,  and  it  grew  and  he  grew;  and,  because  of 
superior  intellect,  he  outgrew  the  cave  and  built  for  himself  a 
hut;  and  because  his  intelligence  further  grew,  he  discarded 
his  hut  and  built  for  himself  a  house — mark  yon,  a  house.  Still 
his  intellect  grew  and  he  traveled;  and  he  saw  the  wonderful 
beauty  of  the  he'avens  and  the  earth,  and  the  sun,  and  the  stars, 
and  the  streams,  and  the  oceans,  and  lo  and  behold!  his  desires 
to  see  all  these  beauties  before  him  at  all  times  were  father  to 
his  attempt  to  reproduce  them  in  his  dwellings!  So  his  intellect 
grew,  and  so  art  was  born,  and  so  man  builds  for  himself  palaces 
and  paints  for  himself  joictures  of  the  things  he  has  seen  in  his 
migrations  and  travels. 


^&' 


THE  CHIEF  FACTORS  INDUCING  COORDINATE 
MENTAL  EFFORTS 

The  Optic  Sense 

A  fact  has  l)een  poorly  stated,  or  a  statement  has  been 
improperly  jn-esented,  unless  it  jjroduces  within  the  mind  of 
the  i^erson  to  whom  it  is  i)resented  a  coordinate  effort  reaching 
out  for  further  information  on  the  same  subject.  Thus  a  suljject 
is  never  closed,  never  completed  until  its  power  to  awaken 
mind-developing  desires  and  efforts  foi-  furtlier  research  in  it, 
has  l)een  exhausted. 

Mental  efforts  are  of  two  kinds — iirni(l-<l('\('l()i)iiig  and  iiiind- 
<li>liii'biiig.  Botli  may  be  coordiiiaie,  and  hotli  may  mean  mental 
activity.  One  is  productive  and  good;  one  is  destructive  and 
Imrlful.  One,  being  goo<l,  is,  of  course,  absolutely  harmless; 
one,  lliougli  hui'trnl,  may,  I'oi'  a  long  jK'riod,  seem  ])ro(luctive 
and  good;  thus  its  malignancy  is  greater  tli.in  il  first  a])])eai"S 
to  be. 

The  things  we  see,  tlic  Ihings  we  lieai'.  Ilif  things  we  lonch, 
the  things  we  i^ead,  nil  indnei-  menial  e(Toi-1s  of  one  kind  or 
another.  Tlu'se  m<  nial  I'lTorls  nrc  crystnlli/ed  into  thought, 
and,  as  tin;  case  may  Ix',  llicse  1li(niglils  maiiii'csi  themselves 
in  oni' acts,  daily  or  nmisn.-il.  IT  the  things  we  see  ai'e  l)eautiful 
t(;  ns,  the  i)leasing  elTeet  upon  onr  retime  is  cnnnilat  i\'e  and  i"e- 


8E(iini;x(;i':  oi'  u'iioicut  zo 

(•urrciil;  and  directly  as  tiio  clTcct  ii])oii  oiii-  \isual  sense  is  tlie 
power  oi'  the  things  we  see  to  induce  coordinate  mental  effort. 
To  see  a  tliiii<;-  heautifid  is  to  loii^-  to  see  more  of  it,  to  l)e  near 
it — tliat  is  the  iirst  mental  elTort  induced  upon  us.  Although 
some  may  not  consider  it  so,  in  the  ultimate  analysis  we  learn, 
nevertheless,  that  it  is  so. 

AVe  go  forth  on  a  liot  summer  day  to  find  the  cooling-  com- 
fort of  some  wooded  country  section.  AVe  enter  the  confines 
of  this  section  and  our  visual  sense  is  pleased.  That  pleasure 
is  immediately  reflected  in  our  mental  self,  in  that  it  causes 
ns  to  pause  for  a  fraction,  or  an  hour,  or  a  day,  and  demands 
that  we  look  again,  be  it  at  the  soft  green  of  the  grass,  or  the 
tall  trunks  of  the  trees,  or  the  overhanging  Ijowers  of  whis- 
pering leaves;  and  we  do  look  again,  and,  looking  again,  we  love 
the  scene  more  and  long  more  for  it. 

This  coordinate  mental  effort  is  now  crystallized  into 
thought,  the  greatest  abstract  force  in  the  universe,  and  thought 
now  manifests  itself  in  our  very  next  act.  AVe  cast  about  for 
a  means  tliat  will  enal)le  ns  to  see  and  aljsorb  more  of  the  beauty 
at  hand  with  the  least  expenditure  of  i:)liysical  effort.  It  is  not 
essential  that  we'  see  this  green  grass,  these  tall  trees,  or  leafy 
bowers.  AVe  may  will  for  them  only,  and,  if  our  mental  effort 
in  that  direction  l)e  acute  enough,  we  may  run  through  the 
same  cycle.  Thus  we  have  the  will  producing  a  mental  eft'oit, 
crystallizing  into  thought,  manifesting  itself  in  a  distinct 
physical  act.  There  is  the  subconscious  inental,  the  conscious 
thought,  and  the  i)hysical  manifestation. 

The  will  to  call  forth  the  mental  impression,  crystallizing 
into  thought  on,  and  of,  beautiful  things, — such  thoughts  later 
manifesting  themselves  in  onr  respective  acts — while  calling 
for  both  mental  and  physical  activity,  is  in  no  way  hurtful  or 
exhaustive. 

AA^e  leave  our  enchanted  little  Eden,  or  oasis,  and  come  out 
into  the  broad  grass  jjrairie  shriveling  beneath  brilliant  rays 
of  the  noon  sun.  AVe  are  as  yet  in  the  grasp  of  the  be'autiful — 
aware  of  the  effect  produced  upon  us  by  our  communion  with 
the  beautiful — and  the  sum  total  of  this  effect  is  in  the  jDeriod 
of  transition;  that  is,  in  the  process  of  being  stored  uji  within 


26  CAST    GOLD    AXI)    POIICELAIX    INLAYS 

the  memory  cells  of  that  joart  of  our  brain  Avliicli  concerns 
itself  with  the  doings  of  our  subconscious  ego.  We  see  nothing 
of  the  dying  grass  or  grain,  our  feet  move  lightly  over  the 
parched  earth,  while  our  eyes  are  turned  upward  in  awe  and 
wonder  and  admiration  of  that  wonderful  hall  of  shooting  tire 
sending  out  rays  that  light  and  heat  and  stimulate  to  growth 
a  billion  and  half  of  people,  and  a  quintillion  and  a  half  of 
animals.  As  Ave  look  upon  it  we  wonder,  and  Avill  to  look  upon 
it  more,  and  that  mental  effort  crystallizes  into  thought — coordi- 
nate, all  coordinate— and  yet,  what  is  this  physical  act  now 
manifesting  itself?  To  be  sure,  we  might  have  known,  the  rays 
of  the  sun  blind,  hurt,  and  cut  the  eye;  and  so  the  hand  goes 
up  to  shield  the  careless  member.  Now,  as  in  sheer  pain  we 
look  down  at  our  feet  and  visually  sweep  our  immediate  sur- 
roundings, we  see  that  the  rays  that  light  may  also  ignite,  the 
rays  that  heat  may  also  scorch,  and  the  rays  that  stimulate  may 
kill.  We  slowly  begin  to  realize  that  we  have  mistaken  a  mind- 
disturbing  mental  effort  for  a  mind-developing  one.  Both  are 
coordinate,  or  may  be;  both  mean  mental  activity.  One  is  pro- 
ductive and  good;  one  is  destructive  and  hurtful.  One  in  being 
good,  is,  of  course,  absolutely  harmless;  one,  though  hurtful, 
may,  for  a  long  period,  seem  productive  and  good.  Thus  the 
malignancy  of  some  mental  efforts  is  greater  than  it  tirst  ap- 
pears to  be,  as  shown  here  above. 

The  Auditory  Sense 

The  tilings  we  hear,  liow  ])owerful  a  factor  are  they  in 
arousing  us  to  mental  efforts,  mind-developing  or  mind-disturb- 
ing, as  the  case  may  Ix'!  Because  of  things  heard,  empires  were 
born  and  destroyed,  maps  of  continents  were  changed,  armies 
faced  one  another  in  gory  contests,  and  innumerable  lives  were 
sacrificed  u])Oji  tlic  aUai-  of  gossip! 

Kiishna,  Confucius,  Buddha,  and  Moses  heard  the  voice  of 
tile  great  Universal  ^liud,  or  Si)irit,  or  Soul,  and  the  fate  of 
millions  was  changed.  Pliai'aoli  heard  llie  xoice  of  Moses,  and 
tlie  children  of  Israel  were  free  to  follow  llie  gical  leader.  Yes, 
and  llie  eliildreii  of  Israel  heard  llie  voice  of  discontent  and 
gi-(  ed,  and  lliey  were  i-eady  to  follow  the  ,ii-ol<leii  calf.     (1eo])atTa 


SEQUENCE    OF    'I'llorcilT  27 

heard  ol'  llic  ^I'eat  ^Vjitoiiy,  and  tlie  coii([U('st  of  Egypt  Avas  for 
the  time  beiii<i,'  forgotten.  Octavius  tlicn  licard  the  voice  of 
opportunity,  conquered  Egypt,  and  Cleopati'a  died. 

Like  other  great  leaders  mentioned,  Jesus*  lieard  tlie  voice 
and  transmitted  and  translated  it  to,  and  for,  the  peojjle,  in  the 
shape  of  a  doctrine  of  righteousness  and  goodness  and  peace  and 
tranquillity  and  hapi^iness.  The  people  were  free  to  follow  if 
they  willed,  and  some  did;  but  the  great  number  heard  the 
voice  of  doubt,  and  they  are  still  traveling  in  the  desert. 

The  voice  Jesus  heard  and  gave  to  the  people — what  has 
become  of  it,  and  what  have  they  done  with  his  teachings  ? 
There  are  a  dozen  different  sorts  of  Christians,  each  proclaim- 
ing themselves  the  right  sort  and  real  original  followers  of 
Him  who  heard  the  voice  and  told  freely  of  what  He  heard, 
and  none  of  the  different  ones  professing  belief,  have  faith 
enough  to  realize  that  they  themselves  may  hear  the  great  Voice 
if  they  but  will  to  hear  it.  But  they  have  heard,  instead,  the 
voice  of  doubt,  and  the  mirage  upon  the  sands  of  their  own 
mental  desert  lures  them  astray. 

And  we,  avIio  some  time  or  other  go  forth  upon  some  pleas- 
urable little  excursion  and  perhaps  lose  our  way  for  a  spell  in 
the  tranquillity  and  peace  of  the  forest,  may  just  be  fortunate 
enough  to  come  upon  some  l)ird  singing  his  love  song  to  the 
creative  spirit.  As  we  hear  the  wonderful  notes  tumbling  over 
one  another  in  their  eagerness  to  arrange  themselves  into  a  per- 
fectly wonderful  symiihonic  harmony  of  aj^preciation  and  joy, 
we  are  enthralled  and  roused  at  once.  That  is  the  imj^ression, 
is  it  not?  Xow  comes  our  mental  effort  to  follow  each  trill 
and  each  l)end  of  each  note;  and  that  mental  effort — ^^is  it  not 
crystallized  into  thought — that  great  abstract  force  in  the  uni- 
versci — as  Ave  begin  to  think  of  the  wonder  of  it  all  and  marvel 
at  the  beauty  and  its  influence  ujion  us  ?  And  does  not  this 
thought  now  manifest  itself  in  our  very  next  physical  act,  in 
that  our  very  physical  being  smiles  for  sheer  joy,  our  head  is 
erect,  our  ears  are  alert,  our  chest  is  expanded,  and  we  are, 
in  fact,  physically  better  for  having  heai'd  the  voice  that  induced 
the   will   to   cause    the   mental    effort    wiiich    crystallized    into 

*The  name  Jesus  is  here  used  to  epitomize  the  ideal  monotheistic  man,  the 
ideal  Israelite,  who  so  thoroughly  recosnized  his  relationship  to  the  Cosmos  and 
whose   work   has   been    most    ignoi-ed   by   those    who   most    pretend   to    follow    him. 


28  CAST    GOLD    AXl)    POPvCELAlX    IXl.AVS 

tliouglit,  and  wliicli  tliouglit,  almost  instaiitaiieoiisly,  luaniresti'd 
itself  ill  a  distant  physical  act?  And  again  lot  it  ])c  said  that 
the  will  to  call  forth  the  mental  effort,  crystallizing-  into  thought 
on,  and  of,  beautiful  things,  and  which  thought  later  manifests 
itself  in  a  distinct  physical  act,  Avliile  calling  for  l)oth  mental 
and  i^hysical  activity,  is  in  no  way  hurtful  or  exhausting. 

As  we  leave  the  foliage  home  of  the  Great  Spirit,  the  home 
where  every  tree,  every  branch,  every  leaf,  is  an  altar  of  wor- 
ship and  a  worshiper  at  once,  and  where  every  bird  worships 
his  Creator  in  musical  praise  and  adoration,  we  are  as  yet  in 
the  grasi^  of  symphonic  harmony,  aware  of  the  effect  loroduced 
upon  us  by  our  communion  A^itli  the  beautiful,  and  the  sum 
total  of  this  effect  is  in  its  period  of  transition,  so  far  as  we 
are  concerned;  that  is,  it  is  in  the  process  of  being  stored  up 
within  the  memory  cells  of  that  j^art  of  our  l)rain  which  concerns 
itself  with  the  doings  of  our  subconscious  ego. 

We  are  out  of  the  foliage,  into  the  field,  with  a  clear  view 
for  rods  ahead  of  us,  and  we  see  in  the  distance  swarming 
masses  of  people ;  we  realize  suddenly  that  some  sound  is  crav- 
ing our  aural  attention.  It  is  music  too.  The  will  to  de.termine 
the  change  as  to  kind  causes  a  mental  effort  to  comjiare.  No, 
it  is  not  the  immaculate  trill  of  the  song  bird, — not  the  'pcr- 
fect,  the  beautiful,  the  soulful  harmony  of  the  feathered  little 
interpreter  of  the  divine  language  of  perfect  trust  and  under- 
standing. It  is  the  intensely  electrifying  call  of  a  l)ugle  that  wc 
hear, — that  is  the  thought  crystallized  from  llic  mental  effort 
to  compare,  Avhich  in  turn  was  caused  by  our  \\  ill  to  determine 
the  change  as  to  kind;  aixl  thai  crystallized  tliouglil  now  mani- 
fests itself  in  a  distinct  physical  act,  in  that  \vc  hasten  our  walk 
to  more  quickly  reach  the  field  of  action.  Kapidly  we  walk 
onward,  our  eyes  fixed  upon  the  swaiining.  Icfining  mass,  our 
scnso  of  hearing  alert  to  every  incisixc  call  of  llie  bugle,  iiiiei-- 
rupted  and  augment'  d  now  and  llien  by  1lic  thunderous  Ix'ating 
of  the  dium. 

Instinctixely  we  iealiz<,'  that,  as  a  part  ol'  the  teeming, 
swarming  mass  of  men,  we  are  facing  some  sort  of  a  crisis. 
W'e  ai'e  near  enough  intw  to  recognize  that  two  o|»j)osIng  armies 
ai'C  engaged  in  a  hand  to  hand  baitle;  we  hear  the  ehmg  of  the 


SEQL'EXCK    OF    Tllorcill'i:  29 

bayonet  and  tlic  i-ays  of  llic  sun  seem  to  dissohc;  tlie  l)lades 
into  an  ever  Jn  avin<;'  ocean  ol*  scintillating  steel.  Ujion  a  hill 
not  far  distant,  the  arliih'vy  is  rcverishly  working  to  get  the 
rapid-liring  gun  into  action;  and  now  the  i)rophet  of  death  and 
destruction  and  desolation  speaks  in  a  staccato  of  killing  syl- 
lables. And  man,  ilie  image  of  (lod,  kills;  and  man,  the  image 
of  God,  dies, — a  roar  of  victory,  mingled  with  a  cry  of  j^ain! 

The  bugle  calls,  the  drum  encourages,  the  army  rushes 
forward,  the  conquered  slowly  retreat.  Another  roar  of  the 
cannon,  another  Gatling  gun  address  from  the  hilltop,  and  more 
tilings  made  in  the  image  of  God  see  no  more,  hear  no  more,  and 
work  no  more.  The  conquered  host  becomes  disorganized  and 
breaks  into  a  demoralized  run,  leaving  the  field  of  conquest 
strewn  with  the  bleeding  dead. 

Tremblingly  we  hear  the  bugle  call  again,  a  long  call,  a  sort 
of  minor  note,  plaintive  and  gladsome  at  once,  followed  by  an 
insistent  and  imperative  order  to  desist  from  pursuit  and  cease 
firing. 

The  battle  is  over,  AVe  realize  somewhat  hazily  as  yet,  that 
somehow  humanity  has  been  weighed  and  found  wanting,  that 
it  has  been  tricked  by  its  own  lack  of  understanding,  AVe  can 
see  the  suffering  thousands  writhing  in  the  death  agony  of 
man-inflicted  wounds,  AVe  can  picture  to  ourselves  the  thou- 
sands of  homes  of  mourning,  of  despair,  of  desolation.  AVe  see 
widowed  women,  orphaned  children,  starving  families,  uttering 
prayer  upon  prayer,  and  curse  upon  curse.  We  can  see  also  the 
land  of  the  victorious  in  the  throes  of  delirium.  The  news- 
papers are  singing  the  praise  of  the  great  victorious  soldiers. 
The  town  is  decorated  in  their  honor.  AVe  see  the  fireside  of 
the  returned  victor  ablaze  with  light;  joy  seems  to  have  run 
riot  in  this  circle;  a  helpmate  and -clinging  children,  eagerly 
listening  to  his  minute  account  of  the  great  battle;  he  glories  in 
the  mess  of  blood  and  carnage  left  behind  him;  his  face  seems 
transfixed;  his  eyes  are  staring  straight  ahead.  His  finger 
pointing  at  the  imaginary  foe,  he  tells  what  a  wonderful,  mad- 
dening effect  the  persistent  call  of  the  bugle  had  ui^on  his  men — 
how  it  spurred  them  on  to  victory,  and  the  enemy  on  to  death. 

The  reaction  is  upon  us  in  its  full  and  remorseless  effect. 


30  CAST    GOT.D   AND    PORCELAIX    JXLAYS 

Dry  sobs  of  contrition  may  sliake  our  jDliysical  frame,  but  they 
are  as  nothing  to  the  mental  agony  Ave  liave  gone  through. 
AVeary  in  boily  and  mind,  we  ponder  over  the  whole  problem, 
and  slowly  the  mist  begins  to  clear.  With  the  clearing  of  the 
mist,  comes  power  of  greater  mental  vision,  and  we  begin  to 
analyze  the  situation;  to  reach  into  the  vitals  of  the  wherefore; 
to  find  that  humanity  has  bee-n,  and  is  still,  being  tricked  into 
murderous  imj^ulses  and  killing  contests — not  by  the  call  of 
the  bugle,  not  by  the  beating  of  drums,  but  by  a  lack  of  clear 
understanding,  a  lack  of  a  clear  vision,  an  incapability  of  seeing 
the  great  love  light  of  the  infinite  tolerance,  and  absence  of 
unity  of  purpose,  and  a  greedy  desire  for  advantage. 

False  leaders,  joointing  the  road  into  eternal  darkness,  con- 
taminate unto  vileness  the  minds  of  their  weakened  followers 
with  doctrines  that  are  as  ephemeral  as  their  motives  are  greedy. 
They  are  responsible  for  the  mental  misconception  of  real  issues 
by  a  heretofore  real  people. 

A  year  passes  by,  and  the  doctrines  fall  to  pieces — collapse 
because  they  were  built  upon  the  quicksands  of  untruth.  Other 
false  leaders  with  other  false  doctrines  play  their  enticing  tunes 
to  Avin  the  croAvds;  and  so  things  have  been  going  on  until 
man's  mind  (mass  man,  I  mean)  has  become  a  chaos,  a  wilder- 
ness, an  instrument  readily  responding  to  martial  influence!  and 
impulses — ready  ever  to  be  in  on  a  killing. 

The  teachers,  the  leaders,  their  teachings,  and  their  doc- 
trines, are  to  blame.  The  warping  of  the  public  mind  is  their 
doing,  since  they  have  had  the  public  ear;  the  public  eye  has 
been  upon  tliem.  The  misapi^lication  of  the  public's  mental 
power  to  malformed  jjroblems  presented  and  ever  represented 
with  the  sole  purpose  of  so  bewildering  the  public  mind  that 
the  real  issue  will  forever  be  clouded  and  not  be  seen  by  it,  may 
be  laid  directly  at  the  door  of  those  whose  teachings  have  been 
accepted,  and  are  being  followed  by  the  j)u])lic. 

They  have  men  in  such  a  condition  mentally  that  they  will 
stand  up,  face,  and  kill  one  another  for  so-called  good  reasons, 
ever  kept  before  them  by  industrious  exponents  of  the  teach- 
ings; and  should  they  threaten  to  lag  or  <l('imn-  or  should  per- 
chance a  i-av  of  reason  or  li<;lit  enter  tlic  mind  of  llic  killer  or 


SEQUENCE   OF   TIIOUCJllT  31 

vic'tiin,  and  lie  ])e<;'iii  to  doiiht  the  wisdom  of  killing-  or  ])eing 
killed,  llic  heroic  bugler  is  pressed  into  service  with  his  elec- 
trifying clarion  call,  and  the  thunderous  drum;  and  dare-devil- 
ishly, lie  puts  his  entire  lung  jwwer  into  his  efforts  to  rally  and 
encourage  his  comrades  to  face  a  few  bullets  and  perpetuate  the 
system,  always  the  same — the  doctrines  apparently  ever  chang- 
ing with  the  leaders,  but  the  system  always  the  same.  Onward 
C'hristian  Soldiers ! 

And  so  they  rally.  They  hear  the  call  of  the  l)ugle,  and  the 
beating  of  the  drum,  and  that,  to  them,  means  kill,  and  they 
kill.  That  the  bugle  call  is  music  does  not  matter;  that  music 
is  the  immaculate  language  in  which  all  bird  life  sj^eaks  to  its 
creative  spirit  does  not  matter  to  the  system;  that  music  is  the 
infinite  language  that  makes  possible  the  intercommunication 
of  spirits,  even  as  ordinary  words  make  possible  the  intercom- 
munication of  man,  does  not  matter. 

The  soldier,  the  citizen,  the  j^eople,  they  have  been  told 
and  they  know;  they  know,  tliat  bugle  calling  means  rally — 
that  bugle  calling  means  kill;  and  so  to  them  the  waves  of 
electrifying  sound  have  a  destructive  undertow,  the  bewitching- 
tune  of  the  bugle  is  the  reaper's  own,  and  the  symphony  that 
urges  them  on  to  l)attle,  leads  them  unto  death. 

We  slowly  begin  to  realize  that  they  have  mistaken  a  mind- 
disturbing  mental  effort  for  a  mind-developing  one.  Both  are 
coordinate,  or  may  be;  both  mean  mental  activity.  One  is 
productive  and  good,  one  is  destructive  and  hurtful.  One,  be- 
ing good,  is,  of  course,  absolutely  harmless;  one,  though  hurtful, 
may,  for  a  long  j^eriod,  seem  productive  and  good.  Thus  the 
malignancy  of  some  mental  efforts  is  greater  than  it  first  appears 
to  be,  as  shown  here  above. 

The  Tactile  Sense 

"We  have  reached  so  nearly  the  vulnerable  vitals  of  our 
present  civilization,  that  it  will  prove  a  relief  to  retreat  into  the 
past. 

If  we  attempt  to  learn  how  much  of  an  influence  the  things 
we  touch  may  have  in  arousing  us  to  mental  efforts,  mind-devel- 
oping or  mind-disturbing,  as  the  case  may  be,  it  obviously  can 


32  CAST    COLD    AND    POlU'Kr.AlN    INLAYS 

make  littlo  dilTereiico  ^v]K'tlle^  we  are  i)assive  or  aetive  in  our 
process.  In  otlier  words,  for  the  piirjjose  of  consideration,  it 
will  serve  equally  well  to  consider  the  sense  of  touch  as  a  factor 
in  repose,  acted  upon;  or  in  active,  investigating  exercise  of  its 
function. 

Touch  is  first,  accidental,  inii^ulsive,  or  premeditated;  then 
it  is  either  seriously  or  idly  investigative,  defensive  or  offensive, 
jjrehensile  or  repelling,  cruel  or  caressing,  constructive  or  de- 
structive. It  is  therefore,  respectively  pleasing  or  abhorrent, 
and  in  its  final  effect  either  salubrious  or  hurtful. 

Touch,  in  itself  is  a  distinct  physical  act,  either  accidental, 
imjoulsive,  or  premeditated;  and,  being  a  distinct  lohysical  act, 
it  has  behind  it  the  abstract  force  called  thought,  crystallized 
from  some  i^revious  mental  effort.  Our  investigation  of  its  in- 
fluence in  rousing  us  to  mental  efforts  must,  therefore,  be  less 
circumscribed,  but  more  fully  rounded.  To  put  it  into  very 
simple  language,  it  is  a  case  of  starting  at  a  beginning,  com- 
pleting a  cycle,  and  coming  back  to  a  start. 

AVhen  touch  is  accidental,  the  mental  effort  it  rouses  crys- 
tallizes into  a  tliought  which  manifests  itself  into  a  distinct 
jjliysical  act,  which  is  usually  involuntary,  automatic,  and  bene- 
ficial. 

"When  touch  is  premeditated,  it  is,  as  said  before,  the  mani- 
festation of  a  tliought,  or  thoughts,  crystallized  from  a  2;)revious 
mental  effoi't,  and  any  mental  efforts  aroused  by  the  2Jhysical 
act  of  touching  will  l)e  secondary,  coordinate,  and  deductive, 
which  secondary,  coordinate  and  deductive  efforts  will  again 
ci-ystallize  into  coliereni  tliought,  which  thought  will  manifest 
itself  in  a  physical  act.  This  will  go  on  in  rotation,  until  the 
poweT  of  the  thing  we  touch  to  awaken  within  us  mind-develop- 
ing desires  and  crforts  to  fuiHicr  research  in  it  shall  have  been 
exhausted,  for  Hh'  Hinc  being  at  least. 

It  will  \H)i  do  to  continue  this  any  ruithci-  at  picsiuit,  for 
the  simple  reason  that  while  every  statement  made  is  absolutely 
true,  it  does  not  necessaiil}'  follow  that  the  mere  statcnicnt  of  a 
truth  makes  it  acceptable  dogma  to  the  I'eader  or  student. 

►Since  truth  is  conclusi\'e,  it  follows  that  the  student  has  a 
riiiht  to  read  and  review  that  which  led  me  to  ti-uth  and  con- 


SKQUEXCK    OF    TIIOI'CIIT  3.'^ 

elusion,  HO  Uial  he,  llic  stiidciit,  be  eiial)]ed  to  reason  as  lie  reads, 
and  jjerliaps  I'eacli  the  same  eonclusion  as  T,  and  that  before 
having  read  mine. 

And  so  let  us  all  ,i;()  hack  to  the  jxist — not  too  far  baek  at 
once,  lest  we  lose  our  way  in  the  lahyi-inth  of  eternal  time; 
l)nt  let  us  go  hack'  to  the  day  anIicii  Hying  machines  were  not 
a  rcalily.  That  is  not  so  long  ago.  Ihrc  let  us  slop  I'oi-  a 
moment,  to  lind  that  we  were  quite  the  same  people,  with  (piite 
the   same  habits,   opinions,   and   peculiarities  even,   as   we  are 

]10W. 

For  the  i)urpose  of  our  i)resent  jieeds,  we,  therefore,  find 
Mying-niachineh^ss  time  barren  of  attraction,  and  touch  uj^on 
it  only  to  mark  a  mile])ost  on  the  road  u])on  which  we  journey. 
Back  fartlier  we  nuist  go  to  the  next  previous  era  in  the  com- 
])lex  connnercial  growth  of  our  means  of  get-al)outness;  and 
so  we  linger  at  the  point  when  railroads  were  not  in  existence, 
and  scan  this  i^eriod  for  any  ray  of  light  it  may  throw  uiDon  our 
subject. 

But,  first,  we  shall  niai-k  the  place  with  another  milepost. 
AVe  have  wriggled  through  the  underbrush  of  centuries  of  time, 
with  their  obliterating  tftect  of  forgetful ness,  and  we  must  l)e 
careful  to  blaze  the  trail  so  that  we  may  safely  return  to  the 
])resent.  AVe  shall  hnd  ourselves  in  strange  surroundings  upon 
our  return,  else  our  journey  into  the  ])ast  shall  have  been  in 
vain. 

A  railroad  is  a  carrier  born  of  the  human  desire  to  con- 
serve time. 

Time,  next  to  thought,  is  the  most  precious  heritage  of 
man.  Time  is  life,  real  eteriuU  life.  A  waste  of  tiuK?  is  a  waste 
of  life.     Anything  which  conserves  time  conserves  life. 

A  railroad,  as  a  carrier,  shortens  the  time  it  takes  to  reach 
one's  destination  from  a  given  starting  point.  One  can  reach 
two,  three,  or  four  places  in  the  time  it  took  to  reach  one.  The 
railroad  made  four  hours  grow  where  but  one  grew  before. 
To  put  it  diftVrently,  four  lives  are  mine  who  lived  but  one 
before, 

A  railroad  is  great  because  it  serves;  and  its  greatness 
is  in  projiortion  to  the  multitude  it  serves.  More  service — more 
greatness. 


d-i  CAST    GOLD    AXl)    POIU'KI.AI  X     IXI-AVS 

On  tlie  i)riiici])k'  that  no  i)art  can  he  greater  than  the  wliok', 
tlie  railroad  can  not  he  greater  tlnin  he  Avho  conceived  it;  and 
yet  lie  ^vllO  conceived  it  may  find  that  it  out<;•re^^•  his  conception. 

A  railroad  is  definite,  dependahle,  and  helpful  l)ecanse  it 
has  a  plan,  a  starting  j)oint,  and  a  destination.  Nothing  else 
but  good  management  matters.  Given  the  four  mentioned  units 
working  in  unison,  a  railroad  serves,  and,  serving,  heeomes 
great. 

AYe  lived  before  the  raliroads  were  built;  we  lived  quite 
as  long,  but  more  meagerly,  more  slowly,  and  intellectually, 
more  j^oorly.  AVe  could,  in  our  lifetime,  see  but  one  small  part 
of  the  tilings  we  may  see  today,  and  so  we  could,  in  our  life- 
time, learn  to  know  but  part  of  what  we  may  learn  to  know 
today.  Possession  of  knowledge  means  possession  of  power — 
as  the  former  grows,  the  latter  multijolies. 

AVe  were  then  a  people,  slower  of  motion,  more  meager  of 
life,  and  jjooier  in  knowledge;  l)ut  we  were  great;  for  we  con- 
ceived the  thing  we  needed  to  make  us  quicker  of  motion,  less 
meager  of  life,  and  more  wealtli_\-  of  l^iiowicHlge. 

Ours  is  the  railroad  by  right  ol'  conception,  inception,  and 
safe  birth.  AVith  all  its  wonderful  atti'ibutes  and  cumulative 
powers  for  good,  the  railroad  outgrew  our  conception  of  it.  We 
conceived  it  for  service  and  serving;  it  became  great,  and  ha\ing 
become  great,  we  serve  it. 

Like  great  arteries  su])posed  to  carry  life-giving  substance 
to  the  i-einotcst  ])arts  of  the  great  body  of  the  people,  railroads 
now  wind  thcii-  course  through  the  various  sections  of  the  con- 
tinent, but  we,  wlio  conceived  them,  own  thein  no  more;  they 
have  slii)ped  the  iialter  of  the  multitude  and  l)ecome  the  weapons 
of  tlie  few  who  ai'e  evei-  present  in  all  coinnninilies. 

The  ])etter  the  raili'oads,  tlie  nioi-e  (hmgerous  a  weajjoii  in 
the  hands  of  tlie  few,  and  tlie  greatei-  iiienac(>  to  tlie  many. 

So  it  would  seem  that  good  I'oads  are  bad  when  they  ai'o 
very  good,  and  bad  roads  ai'e  not  good  even  because  they  are 
bad. 

But  it  seems  that  the  multitude  might  learn  I'rom  the  rail- 
roads, and  have  a  plan,  a  starting  point  and  a  destination — 
manage  its  affairs  well.     Given  these  units  working  in  unison. 


SKQIIEXCK    Ol'    'I'linlCll'l'  35 

a  iiiullil  u<l<-  shall  scrxc  itscll'  best,  and,  scrxiii,!;',  it  shall  Ix'coine 
o-reat. 

It  niusl  be  r(Miiark(Ml  in  ])assiii<;'  lliat  wo  ai"e  an  impatient 
race,  all  ai)})ar('ii1  ex  idcticc  lo  the  contrary.  AVc  may  he  lazy 
or  indolent  and  our  point  ol'  \\v\\  ])erv(Tted,  hut  we  really  are 
iinj)ati('nt.  wliicli,  if  we  acknow  Icd^c  it,  ])rov('S  that  we  ai'e  ever- 
clianging. 

The  thing  to  do  seems  too  obvious  to  reqnii'e  notice.  If 
our  point  of  vie'^v  is  ix-rvei'ted,  and  wc  arc  im])atient  and  are 
ever-changing,  then  in  ordcn-  to  turn  all  our  seeming  deti'imcnts 
into  benefits,  we  need  but  change  our  point  of  view;  for  that 
becoming  correct,  and  we  being  impatient,  and  we  ever-chang- 
ing we  should  then  change  in  the  direction  of  greater  growth 
and  consecpiently  ])rogress. 

Our  view  was  not  always  2:)erverted,  for  taking  our  im- 
])atience'  for  granted,  we  have  progressed  in  a  way,  or  we  never 
could  have  conceived  the  railroads.  The  heavens  are  not  al- 
ways immaculate,  and  the  earth  is  not  always  wicked,  but  one 
would  not  dream  of  asserting  that  heaven  was  heaven  because 
it  is  not  always  innnaculate,  and  that  the  earth  i)ersists  because 
of  its  wricked  intervals. 

Good  never  comes  from  evil,  but  makes  itself  felt  in  sj^ite 
of  it;  and  so  our  ])rogress  has  come,  not  l)ecause  our  point  of 
view  was  perverted,  not  because  we  were  lazy  or  indolent,  etc., 
but  in  spite  of  these  things. 

Our  restlessness,  our  im])atience,  in  their  spasmodic  efforts 
to  rouse  us,  overcame  our  indolence.  Oui-  needs,  manifesting 
themselves,  the  spark  of  intelligence  was  fanned  into  the  flame 
of  invention.  The  results  were  progressively  and  cumulatively 
good,  until  our  dehnite  intention  to  grow  was  blurred  by  our 
worship  of  the  evidence  of  our  growth,  and  we  ceased  growing 
to  serve  growth. 

What  has  been  said  of  the  railroads  applies  to  the  steam- 
ships, and  in  sequence  to  the  horse,  and  the  sailing  vessel,  and 
again  in  sequence  to  the  ox-team  and  the  rowboat,  and  in  se- 
quence again  to  man's  travel  on  foot  and  to  the  log  w^hich  served 
him  in  crossing  the  first  body  of  water,  which  interposed  itself 
between  him  and  further  lands. 


36  CAST    COLD    .\Xn    POr.CELAlX    JXLAYS 

A  huge  reel  of  filiii,  rich  in  telling  and  epocli-niaking  events, 
unrolls  itself  before  our  mental  eye,  and  we  see  the  civilization 
of  today,  and  of  yesterday,  of  this  year  and  yesteryear,  and  of 
this  century  and  tlie  last;  and  through  it  all,  perhaps,  the  same 
tigure  of  man,  the  same  grace  of  Avoman.  AVe  see  the  almost 
ideal  Switzerland,  the  would-he-right  Xew  Zealand,  England 
and  its  Monarchy,  France  and  its  Kepuhlic.  Russia  rises  and 
growls  at  us  and  reveals  one  of  the  bloodstains  of  the  last 
centuries.  Turkey  staggers  under  her  misdeeds,  and  we  call 
Germany  efficient.  More  films  are  seen  as, we  go  deeper  into  the 
past.  "We  see  Austria  l)orn  and  Spain  at  its  height,  while  the 
l)Oot  of  Euroi^e  attemj^ts  to  crush  the  Hel)rew  race  and  loses 
prestige  for  its  i3ains.  Darkness  alternates  with  light,  the  stars 
are  cloud-obscured,  and  still  perhaps  the  same  figure  of  man, 
the  same  grace  of  woman.  More  films.  The  Eoman  empire  in 
its  i^owerful  strides  towards  the  rule  of  the  earth;  Greece,  the 
beautiful  mother  of  the  beautiful.  The  Huns  terrorize  a  con- 
tinent, and  the  scene  shifts  to  Asia,  to  Africa,  to  America — 
no  matter.  Xow  see  the  Ancients  come  to  life;  the  building  of 
the  house  of  worship  of  one  and  only  one  God  by  the  Jews;  the 
rise  of  the  same  race  from  slaver}^  to  the  position  of  j^owerful 
people.  See  the  munnnies  of  ancient  Egypt,  and  follow  the  lore 
of  the  Chaldeans.  See  Assyria,  Bab^donia,  Arabia,  and  now  see 
Egypt  at  its  height  of  glory  al)out  to  be  huml)led. 

Watch  the  films  and  see  the  dismembei-ment  of  nations,  the 
dwindling  of  powers,  and  the  loss  of  definition  as  to  the  out- 
line, boundary,  and  position  of  authority.  Eons  are  passing  and 
you  must  notf  the  gradual  and  pci'sislciil  cliaiigc  in  ilic  liuiiia]i 
being,  as  we  recede  into  the  hazy  past. 

AVlicn  we  i-each  tlie  beginning  of  tli(^  cave  era  in  the  de- 
veloijnient  of  man,  we  shall  have  gone  back  far  enough  for  our 
present  needs;  for  the  difference  in  tlic  man  ol*  today  and  the 
man  of  erstwhile  cave  time,  is  so  iiiKiiK'slioiiably  a])])arent  that 
no  one  will  fail  to  see  it. 

It  will  be  noted  tliat  we  jiave  retraced  oui-  iiiai'cli  to  the 
])eginning  of  the  cave  era,  and  oiir  reason  for  this  was  to  get 
in  touch  will)  llie  human  while  In-  was  in  a  transition  period, 
about  to  cliiiil)  from  a  lowci-  to  a  liigiiei-  h'\-el;  our  jnirpose  be- 


SEQUENCE    OF    THOUGHT  37 

iii^'  to  asccilaiii  just  what  pai't  the  sense  of  toiieli,  active  or 
passive,  played  in  the  transition  ol'  tlie  animal  hiped,  from  a 
beast,  lacking  in  intelligence,  to  a  ('oni])aratively  intelligence- 
possessed,  nearly  human  being. 

It  must  be  remembered  that  these  heings  were  the  fore- 
runneis  of  man  of  today,  they  lived  in  the  day  and  through 
it  without  a  thought  of  the  morrow.  Might  alone  was  the  tri- 
bunal that  decided  for  them.  Their  members  were  few,  and 
they  had  reached  their  present  stage  in  their  evolutions  from 
the  primordial  slime,  through  no  conscious  cooperation  on  their 
])art.  Like  animals,  they  possessed  the  instincts  of  the  sexual 
urge,  and  the  females  had  perhaps  in  addition  to  that  the  in- 
stinct of  mother  love. 

Suppose  we  select  for  the  i^urpose  of  close  observation, 
three  characters  from  this  unhurried  mass,  and  that  these  are 
Brute  Force,  AVeak  Hands,  and  Lily-white. 

Brute  Force,  huge,  massive,  coarse-featured,  sleejiy,  glut- 
ton-faced, hairy,  small-eyed,  low-browed,  a  voice  like  a  lion's 
roar,  a  rage  like  the  rending  asunder  of  mountains,  slow  of 
motion,  and  inditferent  to  surroundings,  a  consciousness  of 
power,  only  because  bigger  in  bulk  than  the  rest. 

Weak  Hands,  tall,  comparatively  lean,  agile,  restless  of  eye 
and  limb,  rebellious  in  movement,  alert  ever  to  the  imi^ending 
danger  of  crossing  the  path  of  the  Brute,  and  resentful  in  every 
motion  of  his  quick  body. 

Lily-white,  the  female  of  the  sj^ecies,  lithe  in  form,  well- 
shaped  in  limb,  clear-eyed,  well-featured  and  long-haired,  sin- 
uous of  motion,  sensuous  in  the  pursing  of  her  lips.  She  looked 
well  to  the  right  of  her  and  well  to  the  left  of  her,  behind  and 
in  front  of  her.  She  saw  Brute  Force  and  the  likes  of  him, 
and  liked  them  not.  He,  she  figured  in  her  simple  intuition, 
would  crush  her  Avith  his  ponderous  bulk.  She  could  feel  his 
hot  stinking  ])reatli  upon  her,  and  she  reeled  with  apprehension 
and  illness. 

To  him  she  would  mean  nothing — could  mean  nothing — but 
a  mass  to  be  ripped,  torn,  rent  asunder  into  shapeless  chaos  to 
satisfy  his  brutish  sexual  vehemence. 

She  stroked  her  arms,  her  face,  her  breasts  covered  Avitli 


38  CAST    t;()l.li    AND    I'oUCKr.AlX     I.XJ.AVS 

licr  Jong'  lustrous  Jiair,  she  allowe'd  licr  Jiancls  to  gently  caress 
her  belly,  and  she  trembled  violently  as  she  conteinj^lated  her 
heliDlessness. 

And  yet,  there  was  AVeak  Hands,  she  rather  favored  him; 
they  seemed  companions  in  their  fear  of  Brute  Force.  She  could 
contemi^late  cave  relations  with  AVeak  Hands  without  consider- 
iii,i;'  herself  a  shapeless  mass  in  the  aftermath.  She  could  even 
crave  cave  relations  with  Weak  Hands,  for  her  instinct  told  her 
it  was  good. 

AVeak  Hands  was  to  be  considered.  A  leer  came  into  Lily- 
white's  eye.  AYeak  Hands  was  to  be  desired.  She  wanted  him. 
She  would  have  AA^eak  Hands  and  mate  with  him,  in  spite  of 
Brute  Force  and  his  like,  and  just  then  wary  AVeak  Hands 
crawled  out  into  the  open  from  behind  a  rock  and  touched  Lily- 
white  gently.  She  wheeled  as  if  struck  and  they  faced  one 
another  for  a  spell.  On  his  ])ak'  face  she  read  longing  and  crav- 
ing and  passion.  She  saw  his  nniscles  twitch  like  the  twigs  of 
a  young  tree  in  a  fast  wind;  his  mouth  was  open  and  his  lips 
seemed  dry;  his  tongue  seemed  to  fairly  force  his  breath  out  of 
him.  His  eyes  were  fixed  upon  lu  r  and  sccdkhI  to  travel  from 
her  face  down  to  her  well-muscled  abdomen  and  thighs.  Her 
hands  instinctively  shot  out  toward  him,  as  her  legs  began  to 
tremble.  Thus  Lily-white  conveyed  to  A¥eak  Hands  the  mes- 
sage that  she  ^\•as  I'ead}'  to  mate  aii<l  she  \vaiite(l  to  mate  with 
him. 

They  wei-e  foi'ced  to  seelc  cover  h\-  llie  ap])roacli  of  Brute 
I'^oi'ce,  wlio  wns  on  a  liunt  I'oi-  Lily-white.  She  ran  swiftly  in 
one  dii-eetion,  whih'  Weak  I  lands  ci-awled  hehind  the  rock  and 
tlieiHM'  (low  nwai'd  uidil  he  reached  his  eaxc,  into  which  he 
Avriggled.  Here  he  fcdt  safe  from  l>i-ute  Force  and  his  roar. 
Tlie  enti'ance  was  just  l)arely  laigc  enough  to  adinil  the  oecu- 
])an1,  hilt  I'ai-  trto  small  for  the  gi-eat  hulk'  of  the  giant  ehier. 

\\'ea]<  llands  sat  upon  a  stone  and  s1ai'e(|  into  the  seini- 
<larkness  of  liis  ea\<'.  lie  i-eaehe(l  out  with  his  i-iglil  hand  and 
])ieke(|  up  a  stout  stick  that  la\-  there,  to  earelessl)'  toy  with  it. 
His  Jninil  hohlin,:;  the  -tick  nioxcd  ;iinilessl\-  across  the  llooi"  of 
his  cave  inini<M|i;it<l>'  in  front  of  him,  nnd  in  its  wanderings, 
the  sticl\'  enibeddiMl   it-cIf  in   a  jagge(|   hole  of  a  I'ound    jjiece  of 


.SEQUENCE    OF    THOlcniT  39 

stone.  Weak  Hands  lu^\i;('(l  at  the  stick  to  ti'cc  it  tVoin  its 
prison,  hul  in  \aiii.  His  inal)ility  to  S('|)ai'al('  the  two  t]iin;;s 
irritated  liini.  The  small  piece  of  stone  was  held  in  j^laee  ))y 
a  larger  piece  of  the  same  material,  and  tlic  stick  was  held  in 
the  jag<;ed  hole  of  tlie  smaHer  stone.  The  constant  tn^'^in*;-  of 
Weak  Hands  tinally  moved  the  lar^'er  stone  and  snddeidy  tiie 
queer  conil)ination  of  stick  and  stone  held  in  the  right  liand  of 
"Weak  Hands,  as  liherated,  and,  describing  an  arc,  tlie  stone 
struck  tlie  cave  dweller  full  on  the  tein])le,  while  he,  losing  his 
l)alance,  found  himself  on  the  ground,  speculating  as  to  the 
l)eculiar,  strange,  and  unfriendly  behavior  of  his  stick  and  stone. 

A  change  came  over  tlie  cave  man.  He  raised  himself  care- 
fully and  very  slowly  into  a  sitting  j^osition,  and  he  looked  first 
at  the  stick,  then  at  the  stone  on  the  end  of  it;  then  he  deliber- 
ately felt  his  head  where  it  had  come  in  contact  with  the  stone, 
and  then  he  again  looked  at  the  stone  and  the  stick,  brought 
them  nearer  the  entrance  and  the  light,  in  order  to  discover 
the  source  of  its  power.  With  that  end  in  \ie\x  he  swung  it 
slowly  and  gingerly  toward  his  head.  In  spite  of  his  care  the 
force  of  the  contact  startled  him  and  he  tried  again,  tliis  time 
on  his  thigh.  The  result  was  a  grunt  of  i)ain  and  satisfaction — 
if  we  can  conceive  any  such  combination. 

We  may  recognize  now  that  there  was  no  aimless  move  to 
be  detected  in  the  activity  of  Weak  Hands.  He  was  alive,  and 
intelligence  was  dawning;  that  means  that  his  movements  had 
behind  them  the  quality  of  volition.  The  accidental  and  then 
the  premeditated  touch  or  l)low  he  had  given  himself  started 
things  going  in  his  mind.  The  touch  roused  a  mental  effort 
which  crystallized  into  thought,  and  these  thoughts  were  mani- 
festing themselves  in  his  immediately  following  physical  acts, 
as  we  shall  see  directly. 

Weak  Hands  crawled  out  of  his  cave  into  the  great  oi)en 
and  stood  erect.  In  his  right  hand  he  carried  the  wonderful 
stick  and  stone;  he  l)rought  it  up  directly  in  front  of  him  and 
studied  it  in  awe  for  a  spell.  Suddenly  he  grasped  the  stick 
firmly  at  the  extreme  end  and  swung  it  with  all  the  force  that 
was  in  him  to  send  the  stony  end  of  it  swishing  into  the  earthy 
side  of  his  cave,  burying  the  stone  from  sight.     Weak  Hands 


40  CAST    COT.D    AND    POllCKLAlX    IXLAVS 

^vas  teiisi'ly  alert  now.  lie  witlidrew  liis  iiiid  inid  looked  at  it 
again.  It  was  none  the  worse  for  its  work.  He  handled  it 
earet'ully  now — we  might  say  he  fondled  it;  he  stroked  the  stick 
and  stone  with  his  left  hand,  he  brushed  the  side  of  his  face 
against  it,  and  caressed  it  with  his  eyes.  This  satisfied  him  for 
a  few  brief  moments,  then  the  cave  man  became  strangely 
active.  He  found  an  enormous  stone  near  his  cave;  this  he 
moved  up  and  barred  the  entrance.  Then  he  turned  his  back 
upon  it,  his  extended  right  hand  held  the  stick  and  stone  up 
before  and  al)0ve  him;  for  a  moment  his  eye  was  fixed  upon 
the  stone,  and  we  can  see  the  light  of  definite  inalterable  j^ur- 
l)ose  suffuse  his  entire  being;  his  right  hand  droits  to  his  side, 
and  Weak  Hands  is  off  in  his  search  for  both  Lily-white  and 
Brute  Force — and  pray  iiote  he  has  Ijurned  his  bridges  behind 
him. 

AVitli  rapid  strides  he  walked  in  tlie  direction  leading  to 
the  giant's  cave,  a  considerable  distance  off.  From  afar  he  de- 
termined that  Brute  Force  was  asleep;  his  snoring  caused  the 
very  ground  to  reverberate  .  Ijily-white  sat  beside  the  sleeping 
mass  of  l)]iitality.  When  the  familiar  guttural  sound  of  "Weak 
Hands  roused  her  fi-om  her  stu])id  fear,  she  looked,  and  in  com- 
pliance Avitli  an  imperative  gesture  from  the  man  with  the  stick 
and  stone,  she  carefully  crawled  a  few  steps  away  from  Brute 
Force,  then  arose  and  walked  to  meet  her  caller. 

Another  guttural  sound  from  Weak  Hands  and  Brute  Force 
opened  his  small  eyes  to  l)eliold  his  pestering  rival  trespassing 
upon  his  preserves.  With  a  roar  that  struck  terror  to  Lily- 
white  and  brought  her  to  a  standstill.  Brute  Force  was  up  and 
at  her  in  a  moment,  lie  grasped  her  by  the  hair  and  spun  her 
aiound  toward  the  cave,  then  he  made  foi'  Weak  Hands. 

A  hideous  grin  from  his  glutton  face,  liis  ponderous,  liaiiy 
hands  extended  befoie  liim,  he  advanced  toward  the  much 
smaller  AVeak  Hands  wlio  calmly  wailed. 

Tills  irritated  Bi-ule  Force,  he  misse<|  tjie  si)oi't  of  chasing 
the  ferret  as  heretot'oic,  and  it  iionj)lussed  him  sounnvhat  to  see 
anotlier  one  of  the  trilx*  who  dared  stand  si  ill  while  he,  the 
chief,  was  ad\aiicing  jx-llowing  with  I'age. 

The  fiiant  ]'eache(l  out  willi  his  right  lian<l  to  make  shoi't 
woi'k  of  Weak   Hands  when  the  j-ight  hand  of  the  latter  shot 


SEQUENCE    OF    TllorcilT  41 

through  t]i('  air  and  a  ci-asliing  IjIow  I'loiii  the  stick  and  .stone 
rendered  the  w  list  of  \)vn\v  Force's  right  arm  a  mass  of  man- 
gled bone. 

Tlie  brute  stoi)iMM|  in  his  tracks,  confused  for  a  moment 
only,  then,  frothing  at  the  mouth  with  rage,  and  with  his  right 
iiaud  dangling  usek^ssly  by  liis  side,  lie  reached  out  with  Ids 
k'ft  hand  to  wreak  vengeance  upon  the  interloper.  Again  a 
swift  rise  of  Weak  Hands'  right,  a  furiously  fast  traveling,  and 
another  crashing  hh)\v,  and  Brute  Force  was  minus  a  useful 
left  arm  and  i)Uis  two  useless  dangling  members. 

Fily-wliite  crouched  near  the  cave,  transfixed  with  terror 
and  desire,  and  the  other  members  of  the  tril)e  had  been  at- 
tracted to  the  scene  by  the  roars  of  rage  with  which  Brute 
Force  filled  the  air.  They  were  standing  lods  away  and  looking 
on  in  awe  and  fear  and  incomprehension  at  what  they  thought 
was  the  foolhardiness  of  Weak  Hands,  who  alone  seemed  un- 
moved. 

Brute  Force,  his  face  distorted  with  rage  and  pain,  his  eyes 
bloodshot  and  his  hands  dangling  by  his  side,  j^ut  his  mon- 
strous head  forward  and  swayed  toward  this  merciless  physical 
inferior  and  tried  to  l)utt  Weak  Hands,  as  if  he  would  throw 
him  to  crush  him  with  his  feet.  Weak  Hands  stepped  to  one 
side  and  quickly  turned;  with  all  his  might  he  swung  his  friendly 
stick  and  stone  and  l)rought  it  crashing  down  upon  the  skull 
of  the  staggering  hulk.  The  giant's  knees  gave  way  under  the 
])oiiderous  weight  of  the  trunk.  Another  blow  and  Brute  Force 
had  made  the  earth  tremble  with  his  roar  for  the  last  time. 

Some  of  the  members  of  the  tribe  rushed  up  to  Avreak 
vengeance  upon  the  i)resuniptuous  Weak  Hands,  who  smote  the 
foremost  one  a  crashing  blow  upon  the  chest  with  his  weapon. 
The  crowd  fell  back  in  fear,  and  retreated. 

AVeak  Hands  walked  toward  the  giant  and  slowly  touched 
him  with  his  foot.  He  motioned  Lily-white  over  toward  him  and 
placed  his  left  arm  around  her  shoulder;  he  slowly  turned  to- 
ward the  onlooking  tribe  and  motioned  them  to  remove  the  body 
of  the  late  chief.  His  gestures  were  obeyed  with  alacrity  and 
he  and  Lily-white  were  left  alone. 

The  stick  and  stone  were  at  his  right  shoulder,  and  she  was 
in  his  left  arm.    She  looked  at  him  and  marveled  and  trembled 


42  CAST    GOLD   A^'D    r(iKC"EI>AIX    i:XLAY,S 

and  moved  lier  hand  caressingly  across  liis  face,  liis  chest,  his 
arms.  He  looked  at  her  face,  and  her  breast  and  her  hair,  and 
his  arm  grew  tighter  aronnd  her.  His  breath  came  faster  and 
his  nares  ex23anded.  Tims  they  stood  for  a  spell^ — Weak  Hands 
and  Lily-white.  Then  they  raised  their  eyes  to  the  far-off  coun- 
try and  saw  tlie  sun  go  down  to  its  rest. 

It  calls  for  no  very  great  analytic  power  to  enable  one  to 
discern  how  far-reacliing  an  influence  the  sense  of  touch  had 
in  awakening  mental  efforts  within  the  three  characters  in  the 
jjreceding  sketch,  and  it  requires  no  very  keen  sense  of  judg- 
ment to  realize  that  they  were  variously  influenced  by  the  same 
sense  of  touch. 

To  Weak  Hands  the  accidental  touch  meant  the  awakening 
of  a  mental  effort  Avhich  crj^stallized  into  coherent  thoughts, 
which  manifested  themselves  in  a  series  of  distinct  physical 
acts,  i^artly  involuntary  and  automatic,  partly  premeditated, 
and  for  lum  ultimaiely  altogether  l)eneficial. 

To  Brute  Force,  the  i^remediated  touch  or  blow  from  the 
stick  and  stone  controlled  by  Weak  Hands  awakened  within 
him  mental  effort  of  such  low  order  that  it  crystallized  into 
thought  of  such  i)oor  rationality,  that  these  thoughts  manifested 
themselves  in  such  irrationally  aggressive  physical  acts  that 
they  brought  to  him  destructive  tactics  from  "Weak  Hands  and 
tlieir  destructiveness  increased  with  the  irrational  perseverance 
of  offensive  tactics  on  the  part  of  Brute  Force. 

Thus  the  ])('!  roi-nianc(*  went  on  until  the  giant  had  fallen 
an  easy  i)rey  to  tlie  mind-developing  mental  effort  of  AVeak 
Hands,  on  one  side,  and  his  own  mind-disturbing  mental  effort 
on  tlie  othei'.  Xoi'  did  the  cessation  of  the  battle  ])rove  the  end 
of  the  series  of  menial  cIToiis,  ci-ystallizing  thoughts,  and  ])liys- 
ical  acts,  and  again  mental  efforts  and  ciystallized  thoughts, 
etc.,  so  far  as  AVeak  Hands  was  concerned,  and  thi'ougli  him  so 
far  as  Lily-white  was  concei'ucd. 

The  moment  his  loudi  of  the  wenixtn  hecame  |»remeditale(l, 
it  was  tlie  manifeslat  ion  of  a  thonghl  crN  slalli/eil  From  a  pi-e- 
vious  mental  effort,  and.  in  Inrn,  lonse*!  menial  efforts  which 
were  secondai-y.  (••lordiiuilc  ;iii(|  deducliNc,  which  secondary  co- 
oi'dinale  and  dednetixc  nienlnl  effoi-ts  again  ci\vsiallized  inio 
cohereid    Ihonghl,    which    cohei-eiil    Ihonght    again    maiiires1e(l 


si;()ii;.\('K  OF  Tiioi'diiT  43 

ilscir  ill  (lislincl  pliysical  acts.  This  went  on  in  rotation  nntil 
the  power  of  this  newly  found  I'liciid  to  awaken  within  liini 
niind-developin^"  desii-es  for  fuiiher  j-eseai'cli  in  it  or  with  it 
was  exhausted. 

It  is  quite  sale  to  assume  that  this  sti(d<;  and  stone  as  the 
crude  ancestor  of  the  ino(U'rn  scej)ter  lias  held,  an<l  is  still 
occupying-  a  more  or  less  j)roininent  place  within  the  ci'yi)tic 
mind  of  modern  Weak  Hands,  with  henefits  to  some,  and  dire 
results  to  others. 

Reading-  and  Its  Influence  to  Coordinate  Action,  Mental  and 

Physical 

Tlie  tilings  we  see,  the  things  we  hear,  tlie  things  we  touch, 
result  as  shown  before,  in  what  we  think,  and,  as  also  shown 
before,  in  the  things  we  do. 

Xow,  it  is  so  with  some  that  the  things  they  see,  hear 
ami  touch,  rouse  them  to  mental  efforts  whicli  crystallize  into 
thoughts,  which  thoughts  manifest  themselves  in  the  physical 
act  of  writing-  or  recording  what  they  saw,  heard,  and  touched. 

Thus  are  things  recorded,  that  their  contemporaries  or 
posterity  may  learn  of  what  the  recorders,  or  writers,  saw, 
heard,  and  touched,  or  l)y  whicli  they  were  seen,  heard,  or 
touched. 

Seven  thousand  years  of  this  world's  history  have  l)een 
recorded  correctly  and  incorrectly. 

A  great  many  of  the  records  are  mere  guesswork,  and  were 
made  long  after  the  events  to  l)e  recorded  were  su2)posed  to 
have  taken  jjlace.  It  is  only  the  last  few  centuries  that  can  boast 
of  absolute  authenticity  of  chronicled  past  liappenings,  because 
it  is  only  a  few  centuries  ago,  that  it  became  easy  to  record 
tilings  in  so  multi])le  a  way  and  in  so  comprehensible  a  manner 
that  no  doubt  was  left  as  to  the  things  said  to  have  happened, 
having  really  lia])])ened. 

Thus  the  invention  of  the  ])rin[ing-  press  easily  stands  uj)- 
permost  and  foremost  in  the  rank  of  causes  for  pro]ierly  under- 
standing why  humanity  does  not  uiidei-stand. 

This  is  not  written  with  any  attem])t  to  make  it  seem  clever 
— that  is  a  bitter  pill,  which  leaves  a  ]>itter  taste,  and,  sugar  off, 
the  bitterness  remains. 


44  CAST    COLD    AND    PORCELAIN    INLAYS 

Millions  of  books  liave  been  written  by  as  many  writers 
upon  as  many  subjects,  and  tliese  books  have  been  read  by  many 
more  millions  of  readers,  sometimes  for  mere  amusement,  some- 
times in  an  ardent  search  for  truth. 

It  is  only  natural  that  these  readers  should  have  been  in- 
fluenced in  their  directions  and  modes  of  thinking  by  the  crys- 
tallized thoughts  of  the  various  authors  and  since  a  man's  acts 
are  what  he  thinks,  it  follows  that  the  Avork  done  by  the  readers 
was  enhanced  or  adversely  modified  by  what  they  read. 

Thus  we  see  at  a  glance  how  great  a  responsibility  they  Avho 
write  assume. 

The  sum  total  of  all  science  is  already  existing  in  this 
universe,  merely  awaiting  our  discovery  of  it  in  its  affirmative 
actions.  That  is  proved  by  the  wonderful  cosmic  jDrogression 
which  is  taking  place  in  a  definite,  unhurried,  and  absolutely 
irresistil)le  manner,  and  tends  alwa^^s  towards  a  more  complete 
evolution  to  a  higher  tyi^e  from  a  lower  one. 

The  more  complete  a  realization  an  author  has  of  this  won- 
derful cosnuc  urge,  the  more  valuable  in  the  end  will  be  his 
writings  to  his  rea<lers. 

It  ma\'  be  a  novel,  a  treatise,  a  catecism,  or  a  dogma;  all 
tliese  are  valua])le,  if  the  author  realize  the  fundamental  cor- 
nerstone of  all  knowledge  to  be  the  clear  demonstration  of  the 
working  of  all  for  each,  and  of  each  for  all.  In  this  manner 
only  can  he  bring  homo  to  his  reader  a  full  recognition  of  the 
interdependence  of  all  nicdia  in  the  luiiverse,  and  u])on  a  com- 
plete recognition  of  this  interdependence  must  rest  the  basic 
mental  effort  ol'  liis  woilc. 

A  great  ni;iii>-  books  liaxc  been  written  with  an  absolute 
disregard  1o  this  Inilh,  and  ol'ten  in  direct  o])position  to  it,  a 
great  many  of  these  books  lia\'e  been  read  and  accepted  by  the 
readers  as  a  guide  I'oi-  subse(|uen1  thinking  and  hence  actions. 
Thus  the  enoi's  oT  due,  ha\-e  become  the  uiisdced  of  the  many, 
and  the  misdeeds  ol"  the  nian\-  haxc  gi'own  into  a  jihigue  for  the 
whole. 

How  ol'ten  do  we  liejir  the  woi'ds,  "I  should  have  been 
earlier,  if  1  had  not  lost  in>-  wa>',"  and  how  infrequently  do  Ave 
I'calize  the  signiiieaiiec  of  this  ulteranee. 

Jt  is  an  nbsolutc  \';\c\   ili;il   uiilold  men  ;iii(|  women  liaN'e  lost 


SEQUEXCK    OK    Til  ore  I  IT  45 

their  \\a\'  on  their  I'oad  to  coinpU'le  eNolutioii  IVoiii  a  h)\\('i'  to 
a  liiglier  type,  not  peiiiiaiieiitly.  For  that,  because  of  the  irre- 
sistible law  of  eosniic  pro;[;ressioii,  is  iiii])ossil)le;  but  foi-  tbe 
time  beiii"-,  and  they  will  ai'rive,  undoubtedly.  They  will 
awaken  to  throw  off  the  i-etardin<;-  blanket  of  mind-disturbing- 
mental  efforts  and  strike  out  into  the  ])road  highway  of  elear 
undeistanding.  They  will  come  under  the  inlluence  of  mind- 
developing  mental  efforts  and  they  Avill  arrive,  for  can  we  not 
recall  the  sentence,  "I  shall  light  a  candle  of  understanding 
within  their  hearts,"  which  means  that  they  who  have  eyes  shall 
see,  and  they  who  have  ears  shall  hear! 

It  does  not  matter  iiow  many  beings  are  at  present  in  the 
grasj:)  of  misunderstanding;  that  is  it  does  not  matter  so  far 
as  the  ultimate  result  is  concerned.- 

The  one  regrettal)le  fact  is  that  these  beings  are  so  to 
speak  in  bondage  so  long  as  they  persist  in  their  course.  Ulti- 
mately they  will  turn  about  and  reach  the  destination  assigned 
for  humanity  which  is  complete  evolution.  In  the  interim,  they 
will  have  suffered,  and  will  have  brought  suffering  to  many. 
All  that,  because  one  man  was  ])lind  and  recorded  the  black  of 
night  and  called  it  the  ray  of  light. 

It  is  incontroverti])ly  true,  that  idtimately  we  shall  all  have 
a  correct  understanding  of  the  interdei)endence  of  all  media  in 
the  universe,  in  spite  of  all  the  erroneous  theories  spread  by  the 
reading  of  hy])rid  volumes.  They  shall  be  forgotten,  lost  and 
destroyed  by  the  virulence  of  the  thoughts  they  called  forth, 
for  we  see  tliat  everything  in  Nature  tends  ever  to  a  fuller 
expression  of  life,  and  life  means  completeness,  and  the  full 
expression  of  life  implies  hapjnness,  and  happiness  implies  har- 
mony, and  harmony  implies  order,  and  order  implies  projiortion, 
and  proportion  implies  beauty,  and  (lest  we  forget)  the  will  to 
call  forth  the  mental  impression,  crystallizing  into  thoughts  on, 
and  of,  beautiful  things;  such  thoughts  later  manifesting  them- 
selves in  our  respective  acts,  while  calling  for  both  mental  and 
i:)liysical  activity,  are  in  no  way  hurtful  or  exhausting. 

Thus  we  recognize  the  existence  within  us  of  an  inexhaust- 
ible supply  of  energy  to  oppose  and  surmount  the  deleterious 
and  self-destructive  influence  of  the  secondary,  though  coordi- 
nate, mind-disturbing  and  incorrect  mental  efforts  awakened 


46  CAST    (_;()LI)    AND    rOF.CEI.AlN    JNLAVS 

by  the  inhid-disturl)!!!,!;'  j)r()])a.i;aii(la  of  tlic  iiiii'ortuiiate  auihor.s 
of  misfortune  si)rea(liii,i;'  thoiiglits. 

If  a  more  concrete  example  of  tlie  influence  of  reading  in 
rousing  ns  to  mental  efforts  be  required,  I  would  sulnnit  for 
your  consideration,  the  reading  of  Kipling's  "If."  It  is  in- 
spiring and  powerful,  and  throbs  with  the  essence  of  truth  and 
purpose  and  a  lofty  ideal.  It  will  stir  you  with  its  mighty  pur- 
pose for  liumanity's  growth,  and  it  will  awaken  within  you, 
mental  efforts  Avhich  will  crystallize  into  thoughts,  which 
thoughts  will  manifest  themselves  in  your  physical  acts.  You 
will  know  more,  think  more  clearly,  and  work  better;  and  all 
these  enhanced  activities,  though  calling  for  an  apparently  in- 
creased expenditure  of  both  mental  and  physical  effort,  will 
prove  in  no  way  hurtful  or  exhaustive. 

Again  I  would  submit  for  your  consideration,  Tom  Moore's 
"Veiled  Prophet  of  Khorassan."  It  will  rouse  you  and  thrill 
you,  and  shake  you  and  wa]<;e  you,  and  almost  kill  you  with  its 
insane  emotions  of  tli(^  insane  x)rophet  and  his  benighted  fol- 
lowers. 

It  will  rouse  you  into  mental  efforts  which  will  crystallize 
into  thoughts,  which  thoughts  will  proba])ly  manifest  themselves 
ill  tiic  physical  act  of  your  nausea.  It  will  leave  you  less  virile, 
more  fretful,  and  almost  consume  you  with  the  fury  of  your 
anger  at  one  of  thousands  who  have  duped  the  world's  inno- 
cents, and  are  still  (lu])ing  them  to  the  holy  tune  of  "Blessed  are 
11i('\-  lliat  know  not  and  believe." 

A  Consideration  of  the  Foregoing  Plus  Our  Ideal 
of  a  Task 

If  we  read  the  foregoing  carefully  and  follow  the  tieiid 
of  the  thouglit  it  expresses,  we  must  realize  that  usually  our 
thoughts  and  deeds  ai'e  1iiige(l  to  a  great  exleiil  willi  the  hues 
of  llie  deeds  of  those  that  have  gone  before,  and  we  realize  also 
that  in  this  manner  are  traits,  habits,  and  usages  formed  and 
confirmed. 

If  that  were  a  fixed  iMile  in  the  exoliit ionary  strife  of  the 
cosmos,  there  would  l)e  cosmic  ]-e])etition  instead  of  cosmic  pro- 
gression, and  there  would  l)e  no  need  whatever  to  attempt  to 


SEQUENCK    OK    Tl !()('( ;  I  IT  47 

t'onii  a  new  sjK'clral  aspect  of  tliiiii^s  in  ^('iici-al,  and  tliis  ])art 
oL'  wliat  sliall  ))i'()\(>  a  i-ccrcalivc  ai-1   in  |>ai'1ic'ular. 

But  tliis  is  not  a  i'wvd  rule,  t'orluiiatcly,  and  tlio  fixity  and 
induent'O  of  tliis  rule,  or  rat  her  tcudciicy,  vai'ics  inversely  witli 
the  number  of  humans  that  stai1  tlieii-  tasks,  no  niatier  what 
they  be,  from  the  standpoint  of  sim])h'  feeling. 

Now  what  docs  tliis  mean?  It  m(*ans  .just  this:  AVe  seek- 
to  express  in  our  work  that  which  we  I'eel  we  would  have  the 
work  he,  and  that  hrings  us  to  the  prohh'in  of  attempting  to 
i'eel  ourselves  to  be  so  possessed  by  our  ideal  of  what  we  wisli 
to  do,  that  our  aecomi)lisliment  of  the  deed  will  he  a  ])hysical 
manifestation  of  what  our  ideal  of  it  was. 

If  the  sum  total  of  our  efforts  in  this  cosmic  certitude  he 
nothing  hut  a  reflection  of  the  mental  eiforts,  crystallized 
thoughts,  and  physical  acts  of  those  who  were  here  before  us, 
or  even  here  now,  plus  the  expenditure  of  a  given  amount  of 
energy,  then  the  most  we  can  hope  for  is  to  make  fairly  accurate 
constructionists  or  analytic  scientists  of  ourselves. 

But,  if  we  take  what  we  see,  hear,  touch  and  read,  and  care- 
fully absorb  what  is  thus  offered,  and  then,  putting  these  into 
the  background  for  a  moment,  start  our  task  with  an  ideal  of 
what  we  wish  to  accomplish;  in  other  words,  if  we  feel  Avliat 
is  required,  and  we  have  a  conception,  an  ideal  of  what  the  thing 
that  is  required  must  look  and  act  like;  that  is,  if  we  start 
our  task  from  the  standpoint  of  simi)le  feeding,  we  have,  not 
only  the  chance  but  the  assurance,  that  our  work  will  transcend 
the  scope  of  simple  mechanics,  and  it  will,  in  truth,  become 
creative. 

The  interdei)endence  of  all  media  in  the  universe  makes  it 
essential  that  we  be  able  to  distinguish  absolutely  between  cause 
and  effect;  and  though  an  effect  may,  and  usually  does,  start 
a  train  of  secondary  causation,  our  ideal  of  a  task  must  be  high 
enough  and  its  hold  upon  us  nmst  be  firm  enough  to  enable  us 
to  see  the  mentally  conceived,  jjliysically  manifest  itself,  devoid 
of  any  limiting  conditions  imposed  by  outside  influences,  of 
what  may  be  an  effect  of  a  secondary  train  of  causation. 

Virtually,  that  is  creation  on  the  level  of  the  human  growing 
in  evolutionary  definition  and  degree. 

For  creation  is  the  inception  of  first  life  from  so))ietJtini/ 
intangible  into  something  tangible. 


48  CAST    (iOLU    AND    roiU'KLAlX     IXLAYS 

SOME    RATIONAL    AND    ACCEPTABLE    CONCLUSIONS 

AVe  must  iiiiderstaiid  and  accept  in  order  to  understand: 

Tliat  tlie  creative  effort  of  the  nniversal  creative  force 
is,  as  said  before,  always  toward  tlie  evolution  to  a  higher  type 
t'l-om  a  lower  one. 

That  Ave  as  humans,  rej^resent  within  ourselves  every  step 
in  tlie  evolutionary  efforts  of  the  creative  force  in  its  attemi^t 
to  advance  from  a  lower  to  a  higher  type. 

That  since  Ave  are  possessed  of  the  qualities  of  life,  intelli- 
gence and  individual  volition,  Ave  may  greatly  aid  in  this  ad- 
A'anee,  or  Ave  may,  in  a  measure,  temporarily  retard  cosmic 
progression  in  the  human,  ])y  either  doing  Avhat  Ave  should  not, 
or  not  doing  Avhat  we  should  do. 

That  since  the  creative  force  is  the  source  of  all  creation, 
it  follows  that  no  one  manifestation  of  the  CA^olutionary  effort 
of  the  creative  force  can  permanently  affect  in  an  ach'^erse  man- 
ner its  hiws  of  growth,  tendency,  and  cosmic  2:>rogTession. 

That  the  acknowledgment  or  the  accei:»tance  of  the  theory 
of  evolution  does  not  ai'gue  against  inception  of  life  in  a  creatiA^e 
sense. 

Tliat  since  the  creative  force  is  the  source  of  all  creation, 
it  must  1)(^  the  source  of  all  first  life  upon  this,  or  any  other 
planet. 

That  it  is  pi-eposterous  to  assume  that  any  man  Avill  spend 
his  entire  time  deA^eloping  any  sort  of  Avork  Avitli  the  sole  ])ur- 
pose  to  ultimately  destroy  every  evidence  of  his  efforts. 

That  it  is  far  more  ])reposterous  to  assume  that  the  creative 
Uivcc  will  tolei'ale  coiidilioiis  wiiicli  tend  to  iiiillilicatiou  of  any 
creative  effoi-t  on  lis  pari. 

That  the  ultiiiialc  imipose  of  llic  crenliN-e  force  is  the  ])er- 
fectioii  of  species  which  ai-c  j)hysical  manifestations  of  its 
varied  activities. 

That,  of  all  these  species,  the  hunum  is  the  closest  relation 
of  the  creative  force,  ])ecause  the  human  ])Ossesses,  not  only  the 
(juality  of  a])])i-eciatioii  of  the  creative  grandeur,  hut  also  the 
])OW('i-  of  iniilalion  ;iiid  ini;i.ul!i;i1  ion,  ;uh1,  1o  a  limited  extent, 
r)i-igiiiation  oi'  creation. 

That  the  creative  forc(;  lias  displaxed  ujjon  a,  stupendous 
scale  the  faculties  of  selection  and  adaptation  of  means  to  ends. 


SEQUKNCH    OF    Tll()l(;ilT  49 

That  the  hiiiium  possesses  these  i'aeulties  to  a  reinarka])le 
degree. 

That  the  purpose  of  tlie  creative  force  toward  the  liumaii 
species  from  the  iirst  inception  of  its  existence  has  been,  and 
is,  that  of  a  gradual,  l)ut  constant,  evolution  from  lielpless  in- 
efficiency to  perfect  type. 

That  perfection  of  tyjjc,  to  be  disi)!ayed  ])y  the  human 
species,  imx)lies  a  jjerfect  equilibrium  of  perfect  organs  \vhicli 
sliall  make  up  the  physical  body  of  the  human. 

Tluit  wlien  tlie  tendency  of  the  creative  force  is  toward  per- 
fection of  type,  that  stage  Avill  ultimately  be  reached  through 
the  aid  of  the  particnlar  species  itself. 

That  the  creative  force  of  the  universe  is  at  our  disposal 
in  direct  proportion  as  we  understand  the  determined  laws  of 
growth,  tendency,  and  cosmic  progression,  and  submit  to  them 
in  order  to  transcend  them. 

That  perfection  of  the  human  species  implies  the  elimina- 
tion of  all  disease  of  mind  or  body.  That  it  implies  also  the 
elimination  of  all  economic  or  social  conditions  which  make  the 
presence  of  disease  j^ossible. 

That  any  individual  or  conununal  tendency  of  the  human 
species  to  oppose  the  general  evolutionary  progression  to  per- 
fect type  is  effectually  counteracted  by  the  creative  force,  in 
that  it  calls  forth  conditions  which  overwhelm  opposition  or  the 
result  of  opposition. 

That  human  misinterpretation  of  tendency  and  purpose  of 
the  creative  force  is  almost,  if  not  quite,  as  old  as  the  first  spark 
of  intelligence  which  appeared  in  the  genus  homo. 

That  limited  intelligence  was  the  cause  of  this  misinter- 
X)  relation. 

That  a  misinterpretation  is  an  error. 

That  an  error  is  a  hindrance  in  the  ])ath  of  our  evolutionary 
cosmic  progression. 

That  as  such,  it  is  in  conflict  with  the  tendency  of  the  crea- 
tive force  which  inunediately  sets  about  to  call  forth  conditions 
to  overwhelm  the  result  of  the  error  and  the  cause  of  it. 

That  hence,  the  healing  art  is  as  old  as  the  first  error  of 
man. 

That  errors  and  accidents  are  the  2:)rimary  causes  of  all 
human  ills,  and  all  accidents  are  errors  of  one  kind  or  another. 


50  CAST    CorJ)    AXD    I'OTvrHLAlX    INLAWS 

Tliat  all  errors  arc  traceable  to  the  as  yet  iiieoiuplete  evo- 
lution of  the  liniiiaii,  ])liysically  and  niciilally. 

And  iinally  that  the  complete  evolution  of  the  human,  phys- 
ically and  mentally,  Avill  be  attained  throuftli  the  properly 
directed  efforts  of  the  humans  themselves,  working  along  and 
in  accord  with  the  universal  laws  of  growth,  tendency,  and 
cosmic  progression. 

The  healing  art  is  as  old  as  the  first  error  of  man. 

The  milestones  that  mark  the  important  events  in  its  ex- 
istence are  the  periodically  determined  incontrovertible  facts, 
which  ^^^ll  finally  make  out  of  the  art  of  healing  the  science  of 
health  restoration  and  maintenance. 

Dentistry  is  the  art  of  restoring  to  use  and  service  dete- 
riorated oral  organs  and  tissues. 

Dentistry  was,  and  to  a  large  extent  still  is,  a  medle,}^  of 
acts  devised  by  humans  to  counteract  the  breaking  down  of  the 
oral  organs  and  tissues  through  disease  or  accident. 

Dentistrj^  is  a  jjart  of  the  healing  art,  and  is  as  old  as  the 
first  error  which  resulted  in  the  initial  oral  or  dental  deviation 
from  the  physiologic,  or  normal. 

The  milestones  tliat  mark  the  important  events  in  its  de- 
velopments are  the  ])eriodically  determined  incontrovertible 
facts,  which  will  finally  make  out  of  the  art  of  dentistry,  the 
science  of  tooth  and  oral  health  restoration  and  maintenance, 
with  emphasis  on  the  maintenance. 

Millions  of  the  Iminaii  species  ai-e  as  yet  in  the  grasp  of 
ills  resulting  from  eri'ors  of  judgment,  and  o])])osed  to  these 
millions  are  a  handful,  wIkj,  under  veritable  inspiration,  are 
doing  the  woik'  of  llic  creative  force  in  bringing  about  con- 
ditions which  \\\\\  iil1iiiial('l\'  iiiak'c  man  understand  that  he  is 
lieaded  in  the  direction  ol'  evoluting  into  a  ])erfect  manifestation 
of  tlie  ci-eativc  force;  that  is,  of  evoluting  into  that  which  it  feels 
itself  to  be,  to  wit:  a  creative  force.  Tlint  handful  of  men, 
working  againsi  wind  would  seem  1o  be  iiisnrnionnlnhle  obsta- 
cles, Avill  be  ti-ium])h;iii1  in  llie  work  in  whicli  they  are  the 
fortunate  instruments. 

11'  we  redeei  for  a  nionienl.  wi'  .-hall  lind  Ihls  xci'y  simply 
and  very  easily  j)rov(Ml. 

We  understand  that  no  one  nmiiifeslalion  of  the  ci'eative 
force  in  the  universe.  Its  vei>-  name  implies,  that  and  the  re- 
growth,  tendency,  ;uid  cosmic  progression. 


SK(M'I'-N'<' 


■I'll  on;  I  IT  51 


Wo  iin(l(M'Hlaii(l  also  llial  man  is  oiw  of  the  iiiaiiircstatioiis 
of  the  varied  activities  of  thai  cicaliNc  loree. 

If  we  iiiKh'Tslaiitl  ihat  ev<  ii  in  Ihcir  iiiost  active  periods, 
liuiiiaii  ills  can  he  hut  a  pail  of  man,  that  is  hut  a  ]»art  of  one 
ol'  the  manit'estat ions  of  1  he  ei-(^ati\('  I'oi-ce,  and  no  ])riiiiary  ])art 
at  alh  then  we  must  rcari/e  how  siiiiph-  and  ])re(lestiiied  is  the 
linal  eoiKincsi  of  all  inlluenees  which  would  tend  to  retard  coin- 
])lete  evolution  alon.i;-,  and  in  accord  ^\itll,  the  laws  of  f^'rowth, 
tendency,  and  cosmic  ])rogrcssioii. 

Xo  one  will  dis])ute  that  the  creative  force  is  tlie  greatest 
force  in  the  univei'se  .  Its  very  name  imi^lies  tliat,  and  the  re- 
sults of  its  efforts  sustain  that  assertion,  and  it  is  concrete 
enough  in  its  manifestation  to  enal)le  even  the  uniniiiated  to 
become  aware  of  its  presence.  AVe  may  even  have  a  very  con- 
crete example  to  illustrate  t1ie  final  victory  for  evolution  over 
cosmic  repetition. 

If  two  forces,  acting  in  opposite  directions,  exert  their 
efforts  upon  a  movable  body,  the  resultant  Avill  he  the  difference 
between  the  two  forces,  and  the  body  will  traN'el  in  the  direction 
of  the  greater  force. 

If  this  holds  true  in  sim])le  mechanics,  how  powerfully  over- 
whelming must  tinally  be  the  triumph  of  the  creative  force  in 
(A'ercoming  the  effects  of  human  error  upon  humans. 

This  also  ex])lains  why  it  is  ])()ssible  for  a  few  men  to 
counteract  conditions  brought  al)Out  by  the  acts  of  untold  num- 
])ers.  The  few  are  working  along,  and  in  accord  with,  the  laws 
of  growth,  tendency,  and  cosmic  progression  of  the  creative 
force. 

It  may  take  a  dozen  years  or  a  dozen  centuries  for  the  cre- 
ative force  to  acconqjlish  its  work,  or  it  may  take  a  thousand 
centuries.  AVho  knows  ?  That  the  work  will  be  accomplished 
is  as  certain  as  if  it  were  a  finished  deed  at  present. 

The  prohlon  flxit  flx'H  n'ho  desire  in  irorl-  irifli  ilic  creative 
force  are  face  to  face  icith,  is,  how  can  they  hest  accelerate 
the  luorh  of  this  creative  force;  and  since  that  problem  is  vni- 
versal,  the  sohifiou  iiiKst  he  one  capable  of  nuiversal  application; 
and  this  means  that  if  ire  are  engaged  in  ajuf  liinna)/  error- 
correcting  work,  ?re  must  attempt  to  so  do  our  work  as  to  make  a 
recurrence  of  the  error  impossible,  or  as  nearly  ihat  as  possible. 


CHAPTER  II 
.  THE  FUNCTIONS  OF  THE  TEETH 

The  teeth,  as  organs  of  incision,  jirehension,  mastication, 
and  as  accessories  of  A^ocalization,  speaking  or  singing,  liave 
these  varied  functions  to  perform.  To  be  best  suited  for  this 
task,  nature  lias  caused  them  to  accpiire,  in  the  process  of  their 
develoi^ment,  certain  qualities  and  certain  definite  structural 
shapes.  Any  deviation  from  their  macroscopic  normality  and 
their  microscopic  organization,  causes  a  lack  of  functional  effi- 
ciency and  interferes  with  their  normal  contribution  toward  the 
maintenance  of  vital  balance.  Hence  all  dental  efforts  should 
be  directed  toward  a  re-creation  of  macroscopic  and  microscopic 
acceptableness  of  these  organs  when  they  require  our  attention 
at  all. 

In  health,  gums,  teeth,  in  fact  all  organs  in  the  animal  body, 
perform  their  function  as  a  matter  of  grateful  exercise  without 
undue  consciousness  on  the  j^art  of  the  animal  contributing  to 
the  maintenance  of  an  efficient  organization,  in  Avhich  the  income 
is  greater  than  the  expenditure  to  obtain  this  income;  but,  in 
order  to  obtain  such  a  condition,  there  must  be  perfect  inter- 
play of  all  organs  making  up  the  animal  body,  and  the  first 
requisite  for  perfect  interplay  is  absolute  lack  of  interference 
])y  one  organ  with  any  other  one  or  more  organs. 

We  have  had  our  lectures  on  anatomy  of  the  teeth,  and  we 
know  what  they  look  like,  or  should  know.  We  have  had  our 
lectures  in  physiology,  and  we  know  what  the  gums  and  the  ad- 
joining structures  look  like  in  a  healtliy  mouth;  we  have  like- 
wise also  been  able  to  learn  the  beautiful  lessons  of  occlusion. 
All  these  should  have  given  us  a  ])icture  of  healthy  conditions 
not  easily  erased.  And  it  is  this  ])icture  we  must  ever  seek  to 
]-e-create,  and  we  can  not  re-ci-oate  it  en  viassc  unless  we  re- 
create it  in  spots  in  iii(ii\i(lual  tcclli  ;iii(l  tlieir  suri-ounding 
gingivae. 

Let  me   call  vour  attention   to   a   reniaikable   realization, 


FUNCTIONS    01'    Till':    TKK'I'H  53 

which  must  come  to  all  of  us  who  wouhl  endeavor  to  obliterate 
the  effects  of  human  error  ujjon  the  human  system.  Every  mol- 
ecule that  makes  up  the  Jiuiiian,  or  animal,  or  plant  body  is  in 
a  state  of  constant  rhythmic  movement,  which  motion  is  in  def- 
inite geometric  rehition  to  the  motion  of  the  molecules  neigli- 
l)oring  it,  which  warrants  the  conclusion  that  the  molecules 
influence  one  another  by  their  rhythmic  movements  to  the  point 
of  causing  corresponding  geometric  gyrations  in  each  other. 

This  is,  of  course,  not  a  matter  of  first  causation;  that  is, 
not  a  matter  of  life  incei^tion,  l)ut  rather  a  matter  of  life  main- 
tenance by  virtue  of  the  maintenance  of  the  equilibrium. 

If  we  conceive  the  animal  as  a  delicate  clock  or  watch,  for 
example,  we  may  ol)tain  a  concrete  illustration  of  the  interrela- 
tion of  all  the  organs.  Let  us  assume  that  we  are  accelerating 
the  minute  hand  of  a  clock  hj  slowly  rotating  it  to  the  right 
(take  out  your  watch  and  make  the  example  more  concrete); 
we  can  readily  understand  that  we  shall  by  this  act  influence  the 
entire  mechanism  to  a  more  accelerated  motion,  and  that  this 
motion  will  l)e  in  definite  relation  to  the  intensity  of  the  acceler- 
ator force,  and  that  there  will  he  a  definite  rhythmic  and  geo- 
metric relation  between  the  motion  of  each  sej^arate  piece  of 
mechanism  which  makes  up  the  whole  of  the  clock. 

If  we  remove  the  influence  of  the  accelerator  force,  an 
inmiediate  rhythmic  and  geometric  adjustment  takes  jjlace,  and 
the  hands  of  the  clock  jDroceed  to  travel  at  the  original  speed. 
This  may  be  called  a  stimulating  interference  with  the  mech- 
anism, and  results  in  a  greater  amount  of  work  or  activity  being 
done  in  a  given  time  than  the  api^aratus  was  intended  for.  If 
we  now  place  the  hour  hand  at  the  numeral  9  and  the  minute 
hand  at  the  numeral  o  and  susjijcnd  a  minute  weight  from  the 
extremity  of  the  hour  hand,  we  shall  have  an  inhibitory  inter- 
ference with  the  mechanism,  resulting  in  a  given  amount  of 
energy  doing  a  smaller  amount  of  the  work  than  the  apparatus 
was  intended  for;  the  spring  will  uncoil  or  attemj^t  to  uncoil  at 
the  same  ratio,  ])ut  its  effect  ujDon  the  wheels,  and  through 
these  upon  the  hands,  will  be  less  marked  than  before;  again 
there  will  be  a  rhythmic  and  geometric  readjustment  to  normal 
when  the  inhibitory  interference  is  removed. 

Up  to  a  certain  point,  tliese  ex2:)eriments  may  be  re23eated 


54  CAST    GOLD    AXI)    POKCKT.AIX    IXLAYS 

Nxitliout  iiii])airiii,i;-  Uw  iiilu'i'dit  \irility  oT  llic  s])i-iii,i;',  l)ut  as 
soon  as  tlie  ])(>int  of  i]iii)ain)ieiit  is  reaeluMl,  a  rlivtliiiiic  ix>- 
adjiistineiit  becomes  impossible,  a  lack  of  loerfect  iiiter})laY  man- 
ifests itself,  resultiii,2,"  in  a  lieedlessjiess  of  expression;  tlie  ])ai1s 
interfere  with  one  another,  and  a  ,2,reat  deal  of  energy  is  ex- 
l)ended  to  In'ini;-  al)ont  a  result;  work  Avliicli  is  as  nnsatisfactoi\v 
as  it  is  nnreliabk\ 

For  the  j^ui'ijose  of  elimination  of  mechanical  shock  to  the 
iiervons  system  during-  mastication,  and  for  the  purpose  of  en- 
hancing the  vibrating  effect  produced  during  vocalization,  be 
it  singing  or  speaking,  also  for  the  purpose  of  minimizing  me- 
chanical injury  to  the  teeth  themselves,  the  latter  are  held  in 
their  bonj'  sockets  througli  tlie  intermediary  agency  of  an  elas- 
tic membrane,  which  is  so  disposed  beneath  and  around  them, 
as  to  fairly  hold  them  suspended  in  a  resilient  cushion. 

The  elastic  fibers  comjoosing  the  membrane  dispose  them- 
selves longitudinally,  diagonally,  transversely,  and  circularly 
around  the  teeth;  they  interlace  with  the  periosteum  and  with 
the  gum  tissue,  and  thus  during  the  exercise  of  dental  function 
they  effect  an  increase  of  circulation  into  the  surrounding  i)arts, 
which  constantly  brings  fresh  nourishment  to  these  tissues. 

The  vei-y  structure  of  this  elastic  m(Mnl)rane  and  its  pecu- 
liar function  precludes  the  jjossibility  of  abundant  blood  supply 
and  makes  it  a  ready  prey  to  inhibitory  interference.  Such  in-^ 
hibitory  intcM'ference  may  be  brought  about  by  impaction  of 
foods  into  what  are  known  as  intei'dcntal  s])aces  or  by  the  ac- 
eumulatiou  of  cah-ilic  matei'ial  known  as  laitai",  either  ujjon  or 
ai'ound  the  neck  of  the  tooth,  or  upon  ])ortions  of  the  I'oot.  The 
impaction  of  food  into  the  intcrdcnlal  spaces  may  be  caused  by 
the  malrelation  of  tlic  adjoining  teclh  (niahx-chision)  or  by  the 
ini])i'ojjei-  restoration  oF  appi'oximal  suiTaces  of  tcctli  calling  for 
dental  attention.  An  inhibitory  interference  may  also  1)C 
brought  about  by  a  bicak  in  the  continuity  of  sui'face  upon  a 
tooth  in  the  region  mentioned.  A  tooth  nia>'  be  inla_\(Ml  and  a 
])ortion  of  the  inlay  material  may  haxc  Ix  en  left  e\t<'nding 
Ix'yond  the  mmgin  of  the  cavity. 

if  |)|-e,-snre  he  exerted  npon  an\-  one  or  two  teeth  ill  the 
mouth,  the  pressure  will  he  t  raii.-inil  ted  in  ;ill  the  siirroiiiiding 
structur(_'S,   and    throii'ih    them    to    all    other    teeth    in    Ihe   same 


FUNCTIONS    01'    Tin;    TKILTII  00 

iiioiilh  ill  a  scries  of  I'liyiliinic  waves  or  iiiKliilations  of  \'ar\'iii;i,' 
degrees,  cliaii,i;iiii;'  llic  physical  oiilliiic  of  the  siinoiiiKliiii;-  stiTic- 
tures  ill  every  direction.  r])oii  the  cessation  of  tlie  j)ressure  a 
rliytlimic  and  geometric  ri'adjustiiiciit  ^vill  take  jilace  in  these 
tissnes  and  a  return  to  a  condition  of  c()iii|)arative  equi]il)riuni 
ohtaiiis.  Where  there  are  no  inhibitory  iiiterrei-ences,  tliat  is 
^vhel•e  the  rehition  of  the  teeth  is  correct,  as  to  position,  con- 
dition and  form,  these  pressure-induced  waves  or  undulations 
may  take  phice  ad  infiniium.  witli  beneficial  results,  because  un- 
der a  correct  coiidifio)/,  iiifcriniltoif  })rcssiire  is  tJte  essential 
sfiiiiul((tii/f/  iufcrfcrcncc  i)ifl nciur/  tni  nicrcase  of  circulation, 
Jjriiigiug  wiilt  it  a  frcsJi  siipijl/j  of  Hufriiiient  essential  to  life 
maintenance. 

AVhen  inliibitory  iiiterrerciices  are  jiresent,  that  is,  wlieii  the 
relation  of  the  teeth  is  not  correct  as  to  position,  condition,  and 
form,  each  pressure  exerted  upon  the  teetli  during  mastication 
causes  the  same  series  of  waves  or  undulations  in  the  soft  tissues 
surrounding  them,  but  each  wave  or  undulation  causes  these  tis- 
sues to  come  in  contact  with  injui-ing  or  l)ruising  obstructions, 
and  the  rhythm  of  recoil  or  readjustment  is  first  interfered  with 
and  ultimately  destroyed. 

Poorly  executed  inlay  restorations  may  ])e  classed  as  in- 
hibitory interferences  with  the  free  and  unliam])ere(l  undulating 
and  very  essential  excursions  of  the  soft  tissues  surrounding 
the  teeth.  They  produce  states  not  conducive  to  the  health  of 
the  individual,  and  are,  therefore,  incorrect  dental  conditions; 
and  any  dental  o])e ration  that  will  entirely  eliminate  them  will 
be  an  operation  conduci\e  to  the  health  of  the  individual,  and, 
therefore,  a  correct  dental  oi)eration. 

All  tissues  must  be  exercised,  or,  rather,  they  must  have 
the  freedom  to  in<lulge  in  such  exercise  as  tliey  need,  and  all 
tissues  of  all  organs  need  exercise  to  kee])  them  from  nnder- 
going  atrophic  changes.  Hence  anything  which  will  interfere 
with  the  free  and  nnhami)ered  undulations  of  the  gum  tissues,  b}" 
any  means  whatever,  results  in  joathologic  conditions  by  bring- 
ing about,  first,  a  lethargic  state  in  the  tissue;  second,  a  dimi- 
nution in  vasomotor  action,  l»ecause  of  lack  of  restiinulatioii; 
third,  an  accumulation  of  waste  material  in  the  cellular  and 
intercellular    sul)stance,    resulting    in    a  rai:)id    death    of   cells; 


OG  CAST    COl-l)    AXD    roilCELAlX    ]NLAYS 

foiirtli,  an  atro])]!}'  or  loss  of  tissue,  resulting  in  a  i)liysical 
cliange  wliicli  makes  it  difficult  to  maintain  a  hj^gienic  balance. 

AVe  may  stimulate  life  processes  and  thus  for  a  time  induce 
a  greater  degree  of  livingness. 

AVe  may  do  this  l)y  relying  on  extei  iial  extraneous,  foreign, 
therapeutic  agents  which  will  act  directly  upon  certain  organs 
and  drive  them  unmercifully  to  greater  activity,  leaving  them 
exhausted  in  the  end;  or  we  may,  by  means  of  air,  water,  proper 
food,  and  careful  exercise,  which  brings  about  intermittent 
pressure,  induce  a  constant  current  of  restimulation,  which  will 
activate  the  life  jorocesses  to  greater  exjDression,  and  so  in  time 
make  them  the  source  of  the  restimulating  factor. 

Life,  in  the  abstract,  general,  or  universal,  unlimited  sense, 
is  a  complete  cycle  of  such  activities  with  the  restimulating  fac- 
tors inherent  in  the  activities  themselves,  so  in  a  sense  these  ac- 
tivities and  life  are  synonymous. 

Life,  in  the  concrete,  the  limited,  the  i^ersonal,  or  particular 
sense,  is  a  complete  cycle  of  such  activities  with  the  restinudat- 
ing  factoi's  inlierent  in  the  activities  themselves,  but  to  the 
individual,  in  a  constantly  less  appreciable  degree,  and  hence 
IH'oducing  a  constantly  diminishing  result  or  activity. 

Like  begetting  like,  this  diminished  activity  will  induce  re- 
stimulating factors  of  minor  influence  upon  the  life  processes, 
the  latter  will  l)ecome  sluggish  and  metamorphosis  sets  in. 

Tlius  we,  as  individuals,  are  subject  to  the  law  of  cliange; 
we  are  not  and  can  not  expect  to  be,  permanent  fixtures  of  the 
great  cosmos  forever  expressing  itself  in  the  creation  of  new 
centei'S  or  vehicles  for  tlie  dis])lay  of  its  cikIIcss  enei-g) . 

For  the  reasons  stated  above,  all  liiiinaii  woi-k  is  limited 
and  transitory,  that  is  nc^t  pennanent  in  its  effects  or  results, 
file  tilings  we  do  are  as  much  subject  to  change  or  metainor- 
jihosis  as  we  ourselves  aic  'I'll is  ayiplies  ])ai-ticularly  to  our 
endeavors,  when  lliey  are  concerned  willi  altein})ts  to  ])revent 
oi-  inhiliit  the  reduction  of  ilial  cncIc  of  our  acti\i1ies  wliicli 
ai-e  synonymous  witli  lil'e. 

We  are  forever  falling  .-liort  oi'  oui-  ideal  <>\'  a  lask  wlien 
oui"  task  consists  in  an  elforl  lo  balance  income  ;ind  e.\|)endilnre 
of  human  eneig-y,  and  it  will  e\'ei'  l)e  so,  no  nialter  liow  we  may 
improve   our  relations   between   oui-   vegelativ(;   and    objective 


!•' UNCTIONS    OF    THI-:    TEETIL  57 

litV,  or  Jiow  inurli  we  may  learn  ol'  llie  mysteries  of  the  bio- 
cliemical  life  processes  tliemselves. 

It  is  e(|iiall>  true  that  constant  effort  for  correct  inuler- 
slaii(liii<;'  of  these  things  must  r(^sult  in  improved  conditions, 
\vliicli  \\\\\  enable  us  to  husband  the  jiow  vastly  dissipated 
energy,  and  so  prolong  our  activities  and  usefulness  to  a  con- 
stantly glowing  degree.  Intuitively  we  are  all  aware  that  this 
is  true,  tiie  l)est  jji'oof  of  it  b(Mng  that  we  are  in  constant  search 
for  means  of  so  improving  remedial  efforts  for  our  jjatients,  that 
they,  the  efforts,  will  result  in  a  harmonious  interplay  of  the 
intact  functionating  organs  and  the  artificial  work. 

AVe  nmst.  therefore,  face  the  self-evident  proposition,  that 
the  cruder  our  remedial  efforts  are,  whatever  organ  we  may  he 
working  upon,  whatever  our  sphere  of  activity,  whether  it  he 
general  medicine,  surgery,  or  the  specialized  field  of  dentistry, 
and  all  its  kindred  divisions,  the  less  acceptable  will  the  results 
be  to  the  other  functioning  organs;  this  means  innnediate  rebel- 
lion on  their  i:)art;  and,  unless  the  cause  he  removed,  must  result 
in  a  physical  state  which  is  physiologically  minus  and  patholog- 
ically plus:  conversely,  the  more  finished  or  refined  our  efforts 
are,  the  more  acceptable  will  the  results  he  to  the  other  function- 
ing organs. 

A  finished  or  refined,  remedial  effort,  in  hehalf  of  any  organ, 
imijlies  a  knowledge  of  its  individual  and  relative  anatomy  or 
physical  relationship,  and  a  comi^rehensive  understanding  of 
the  physiologic  functions  of  that  organ. 

This  brings  us  up  to  the  affirmation  that  teeth  have  func- 
tions (plural  used  advisedly)  and  a  careful  enumeration  and  a 
critical  classification  of  these  functions  are  now  in  order. 

AVe  may  now  record  the  trutli  that  the  so-called  masticatory 
apparatus  is  not  a  separate,  distinct,  and  independent  part  of 
the  human  organism,  hut  a  functioning  nmltiple  member,  or 
cog,  of  a  very  complex  microcosm,  in  the  maintenance  and  pres- 
ervation of  which  it  plays  a  very  important  part.  The  so-callod 
masticatory  api:)aratus  is  not  a  simple  functioning  member 
of  this  complex  machine,  ])ut  is,  in  itself,  a  very  complex  com- 
])onent,  in  that  it  comprises  many  organs  diversely  endowed 
with  si^ecialization. 

The  thing  that  sug<2-ests  itself  first  in  mv  mind  in  regard 


58  CAST    COJ.D    AXD    POECELAIX    INLAYS 

to  tooth  J'liiu'tioii  is  the  rcciijrocat  i'uiictioiis  of  the  teeth;  reeij)- 
rocal  becaii>;e  they  do  some  things  for  the  orgaiiisiu  whieh  does 
some  things  for  them. 

Since  every  oi'gan  of  the  body  i^assiveiy  and  actively  ex- 
ereisCvS  sncli  functions,  these  may  be  called  the  reciprocal  f mic- 
tions, and  nnist  l)e  classified  as  tlie  jnissivc  and  (ictlve  reciprocdl 
fnnctious  of  the  special  organs. 

PASSIVE  RECIPROCAL  FUNCTIONS 

The  jjassive  reciprocal  functions  of  the  teeth  are  defensive, 
cosmetic,  developmental,  and  j^honetic.    (See  Fig.  1.) 

The  defensive  functions  depend  upon  the  gross  anatonty 
of  the  teetli;  that  is,  they  are  so  shaped  as  to  prevent  injury 
to  the  soft  tissues  surrounding  and  supiDorting  them. 

Tlie  cosmetic  functions  depend  upon  the  gross  anatomy, 
geometric  liarniony,  and  the  Inocliemisr}^,  of  the  teeth.  They 
must  be  in  harmony  with  other  features  of  tlie  face,  and,  by 
correct  growth,  inlluence  the  other  features  of  the  face  to  har- 
mony, thus  also  partly  exercising  the  developmental  function. 

The  pJionrfic  functions  depend  upon  the  gross  and  niicro- 
scojnc  anatomy  of  the  teeth  and  their  position  relative  to  each 
otlier.  That  is,  they  nmst  not  only  be  of  a  shape  and  relation 
conducive  to  clear  enunciation,  but  also  of  a  texture  insuring 
tlie  proper  degree  of  resonance  and  vi])ration.  The  latter  part 
of  this  function  we  can  unfortunately  not  restore  by  artificial 
means. 

ACTIVE  RECIPROCAL  FUNCTIONS 

The  active  reciprocal  functions  of  the  teeth  nnist  he  I'ui-ther 
classified  into  general  and  special. 

The  fpnteral  functions  are  cardioauxiliary  or  vasoauxiliary, 
and  syjn])toniatie. 

The  cardioaaxiliarji  mi-  rasodH.riJidi//  finiclio)!  consists  in 
tlie  restimulating  effect,  wlilcli  the  iiiohilil  >•  of  the  teeth  has 
upon  the  circnhil  ion  (>[  the  slrnclnres  in  w  iiich  the)'  are,  and 
with  which  tiiey  are  resilient  1>  Joineth 

\)\  \irlu<'  of  ihis  niohililx,  lhe>-  in(hice  a  rlixthniic  inter- 
mittent  pressure    which,    inimical    to   mid    tissue    stasis,    hi'ings 


I-'UXCTIOXS    OF    TIIK    TKKril 


59 


£.CTICsJb) 


DCFENSlVt     Passi 
Reciprocal  Ti. 


L  (.Ex. fir  EnPOCE^ous)  £ g 

Incision 

Fiy.   1. — Diagram   ishuw  iiiy  reciprocal  functions  of  the  tcetli. 


GO  CAST    GOLD   AND    POECELATISr    INLAYS 

about  a  constant  cliange  of  the  nutrient  elements  traversing  the 
nutrient  channels  of  these  tissnes. 

The  symptomaiic  fiuictions  nmst  be  subdivided  into  struc- 
tural and  positional. 

The  structural  dyinptoinaiic  fuitctiotis  may  be  indicaitve  of 
some  congenital  or  acquired  constitutional  anomaly;  such  as, 
Hutchinson's  teeth,  thyroidal  disbalance  (as  illustrated  in  teeth 
easily  attacked  by  caries),  or  in  the  presence  of  a  marked  pro- 
creative  urge,  often  bordering  on  lack  of  sexual  equilibrium,  as 
illustrated  in  canines  of  decided  prominence  and  marked  pre- 
hensile formation,  reflecting,  perhaps,  the  animalistic  trend  of 
the  individual  in  whom  very  freciuently  also  are  to  be  found 
small  suin-arenal  bodies  with  narrow  cortex,  demonstrating, 
perhaps,  a  greater  procreative  and  a  less  intellectual  mission  in 
the  cosmic  scheme. 

The  positional  sijmpfouuitic  functions  deal  with  the  mal- 
position of  clitferent  teeth  in  the  maxil^  and  mandible,  and  are 
valuable  diagnostic  determinators  in  that  they  thus  unerringly 
point  to  pituitary,  gonadial,  thyroidal,  and  adrenal  disturbances 
which  would  otherwise  be  most  obscure. 

The  special  active  reciprocal  functions  of  the  teeth  are 
coiiinmnal  and  individual. 

The  communal  special  reciprocal  functions  of  the  teeth  are 
alimentary  and  inhibitory. 

The  alimentary  functions  consist  in  the  x^art  they  all  play 
in  the  prepai-ation  of  certain  foods  for  the  process  of  digestion. 

The  inliihiiori)  jiiuctions  consist  in  the  physical  relation- 
sliijj  of  the  teeth  ov  their  I'elative  apposition  mesio-distally  in 
])articular,  so  as  to  retard,  or  limit,  the  latei-oi'otary  motion  they 
ae(|uire  when  in  use. 

The  individual  (unctions  are  those  of  incision,  jirehension, 
mastication,  and  tiituration,  and,  in  the  sequence  enumerated, 
involve  the  incisoj-s,  canines,  bicus])ids,  and  inolais. 

Since  all  functions  are  recriprocal,  there  can  be  no  hxed 
lulc  or  line  of  demarcation  as  to  wJiere  one  stojjs  and  the  other 
begins. 

All  these  enumerated,  classified  and  dissected,  present  them- 
selves vividly  at  some  j)oint,  the  height  of  the  j)ai-ticulai-  func- 


ri'XCTJONS    OF    TIIK    TKKTH  ()1 

tioual  expression,  to  gracefully  and  gradually  merge  or  lose 
themselves  in  those  which  follow. 

Thus  we  have  an  interplay  of  j)arts  devoid  of  harsh  or 
interruptive  demarcations.  A  pleasing  harmony  as  expressed 
in  coordinate  effort,  salubrious  in  effect;  a  song  of  work  as 
marvelously  planned  as  it  is  symphonically  exi)ressed  in  Jiving- 
ness,i  and  yet  more  livingness,  to  the  glory  of  the  mind  that 
l)ade  it  come  into  being. 

SUMMARY  FOR  CHAPTER  II 
The  Functions  of  the  Teeth 

1.  What  is  meant  by  the  reciprocal  functions? 

2.  How  are  the  reciprocal  functions  classified? 

3.  Xanie  the  passive  reciprocal  functions  and  define  each. 

4.  How  are  the  active  reciprocal  functions  classified? 

5.  Define  the  cardioaxiliary  or  vasoauxiliary  functions. 

6.  Subdivide  and  define  the  symptomatic  functions. 

7.  Define  the  following  functions:  communal,  alimentary,  inhibitory,  in- 
dividual. 


CHAPTER  III 
THE  CAST  COLD  INLAY 

Human  teeth  decay  and  become  a  source  of  discomfort  and 
dano-er  unless  tliey  can  be  restored  by  tlierai^eutic,  operative, 
and  iiieclianical  means. 

The  foregoing  is  a  statement  of  facts  that  no  amount  of 
argument  can  dislodge.  It  is  universally  known,  so  far  as  our 
l^rofession  is  concerned,  and  it  stands  as  a  comprehensive  reason 
for  our  entii-e  and  particular  field  of  endeavor.  It,  therefore, 
presents  a  proper  basis  or  fundamental  statement  for  this 
volume,  although  this  volume  concerns  itself  with  only  that 
part  of  corrective  endeavor  known  as  inlay  work  or  the  cemented 
filling. 

This  work,  that  is,  the  restoration  of  a  broken-down  tooth 
by  means  of  a  cast  gold  inlay,  may  be  broadly  defined  as  a  den^ 
tal  operation. 

Any  operation  may  be  correct  or  incorrect;  and  a  correct 
dental  operation  may  be  defined  as  one,  the  result  of  which  is 
conducive  to  the  health  of  the  individual  uijon  whom  the  opera- 
tion is  performed.  We  understand  by  the  term  health,  the  main- 
tenance of  that  vital  balance  which  is  expressed  by  the  normal 
functioning  of  all  organs  which  comi)ose  the  human  body. 

Inlay  work  may  be  divided  into  two  classes,  metallic  and 
iioninclallic. 

Metallic  inlays,  wliidi,  hccausc  of  llicii-  iiiij)ortance  as  tooth- 
restorers,  shall  liaxc  lii-sl  jilace,  arc  those  that  ai'e  made  of 
gold  or  any  allo\  in  which  gold  or  other  suitable  metal  pre- 
dominates. 

The  making  of  metallic  inlays  may  be  brought  about  by  the 
swaging  or  casting  method.  The  foi-mer  are  so  imperfect  and 
have  proved  so  unsatisfactoi-y  that  they  are  becoming  obsolete 
;in(l  will  not  he  considered;  ami  since  gold,  as  a  rule,  ])i'e(lonii- 
nates  in  the  cast  inctallic  itila\-,  it  will  liereal'lei'  he  rerci-rcd  to 
as  ^lie  cast  (jold  liildij. 

02 


CAST    COM)    IXI.AV  03 

yl  cdsl  f/i>l'l  nihljl  liKljl  he  f/c/ilirfl  (is  ii  iiidss  oj  uioltcH 
iiicfdl  Hi/dcr  (Ic/ii/ilc  f/asfous  pi'cs.'^iirc,  forced  ii/lo  (iiul  sliapcd 
in  a  special  nudd,  so  lliaf  ll  iiill ,  upon  cooliiifi  oy  cri/.staUlzinfj, 
accurately  fit  into  the  earilif  of  Ihc  loolh  from  ii-lilcli  the  wax 
pattern  emt)edded  In  the  mold  n'ds  lahcn,  and  iJiat  cool  mass 
of  metal  sliati  in  outline  and  eminences  so  conform  to  the  out- 
lines, and  eminences  of  that  particular  tooth,  and  opposincj  and 
adjoining  teeth,  if  there  he  any,  that  it  shall  form  an  acceptable, 
anatomic,  complement  to  the  tooth  requiring  restoration,  and 
It  shall  mal-e  that  tooth  macroscoplcally  perfect. 

In  short,  then,  a  ca^st  gold  inlay  is  an  accurate  metallic 
complement  to  tJie  macroscopic  anatomy  of  a  hroken-doivn  tooth. 

The  process  of  restoring  broken-down  teeth  by  means  of 
cast  gohl  inlays  consists  of  a  series  of  stejis  or  operations  which 
in  tlieir  proper  seqnence  may  be  enumerated  in  tlie  fodowing 
order : 

1.  Selection  or  election  of  the  case. 

2.  Prei)arati()n  of  tht^  cavity. 

3.  Selection  of  the  proper  wax  and  the  making  and  carving 
of  the  wax  model  ])y  means  of  the  direct  or  indirect  method. 

•i.  Taking  an  imi)ression  of  the  cavit}^  aiid  making  a  die  for 
i:)rocednre  ])y  the  indirect  method. 

5.  Selection  of  tlie  refractory  compound  and  tlie  iml)edding 
of  the  wax  model  to  construct  the  mold. 

().  Drying  out  of  the  mold,  and  the  l)urning  out  of  the  wax 
iikmU'I. 

7.  Casting  of  the  molten  metal  into  the  mold. 

8.  Cleansing  of  the  casting  in  hy droit uoric  acid  and  in  a  so- 
dium l)icarl)onate  l)ath. 

9.  Tvemoval  of  the  sprue,  forming  excess  gold,  and  the 
polishing  of  the  inlay. 

10.  Cementation  of  the  inla5\ 

SUMMAHY  FOR  CHAPTER  III 
The  Cast  Gold  Inlay 

1.  Cliissifv  inlay  Avork. 

2.  What   iiu'tal   is  most   suital)le   for  inlay  casting? 
;_>.  What  is  tlie  function  of  a  cast  g'ohl  inlay? 

4.  What  aro  tlio  st(>i)s  (in  their  pi'oper  sequence)  that  are  Tiecessary  to 
proiluee  a  cast  t^'ohl  inlay. 


CHAPTER  IV 

SELECTION  OR  ELECTION  OF  THE  CASE 
PRESENTING  A  CAVITY 

(A)  Any  tooth  distally  to  the  disto-proximal  surface  of  tlie 
canines,  requiring-  a  gohl  hlling,  can  he  restored  more  perfectly 
l)y  means  of  a  cast  gohl  inlay. 

(B)  Any  lahio-  or  linguo-gingival  cavity  hrrger  in  diameter 
than  o  nnn.  distally  to  tlie  second  bicuspid  calls  for  a  restora- 
tion by  means  of  an  inlay  rather  than  a  malleted  filling. 

(C)  Any  tooth  requiring  restoration  of  proximal  contax:^t 
calls  for  an  inlay  rather  than  a  malleted  filling. 

(D)  Any  tooth  requiring  occlusal  restoration  in  its  relation 
to  opposing  teeth  calls  most  emphatically  for  a  cast  gold  inlay 
in  preference  to  a  malleted  gold  foil  filling. 

(E)  Any  compound  cavity  in  any  tooth,  distally  to  the  first 
bicuspid,  calling  for  a  gold  restoration,  indicates  the  use  of  an 
inlay  rather  than  a  malleted  filling. 

(F)  Every  mesio-disto-occlusal  cavity  in  any  multicuspid 
tooth,  should  be  filled  ])y  means  of  an  inlay  rather  than  a  mal- 
leted gold  foil  filling. 

The  gold  inlay  is  conl  laindicated  in: 

(a)  Small  proximal  cavities  in  the  anterior  teeth. 

(b)  Small  fissure  cavities  in  anterior  teeth  lingually  and, 

(c)  Small  cavities  in  posterior  teeth  occlusally, 

(d)  Small  labial  cavities  in  posterior  teeth  in  mouths  com- 
paratively iiiiiiiiiiic  1o  |)i-ogr('ss  of  decay. 

SUMMARY  rOR   CHAPTER  IV 
Selection  or  Election  of  the  Case  Presenting  a  Cavity. 

1.  Xamc  the  types  of  cavities  when  a  cast  ^old  inlny  is  indicntciL 

2.  Tn  whaf  eases  is  the  inlnv  contrainrlicatcd  ' 


64 


CIIAI'TKIJ   \' 

C'A\'1TY  JMii:PAIJA^ri()X 

GEOMETRIC    LANDMARKS    OF    TEETH 

Tooth  Surfaces  and  Angles 

I^A'ery  incisoi'  tooth  jircsents  for  exaiiiiiialioii  four  distinct 
surraces;  a  cutting',  oi-  incisal  edge,  and  a  nuiiilxT  of  line  and 
point  angles  as  follows:     (See  {Fig.  2.) 

SriiFAC'Hs  OF  Ixcisoit  Tfktji 
Mesml  (1) 
Distal  (2) 
Lahial  (3) 
Lingual  (-!:) 

A  distinct  incisal  surface  at  times  (5) 
AXGLES  OF  IxcisoR  Tp:ETn 
Line  Aiu/lcs 
Alesiodahial   (()) 
^lesio-lingual  (7) 
Disto-labial  (8) 
Disto-lingual  (9) 

Cuffiiiff,  or  Point,  ^iiif/Ies 
Mesio-lal)io-incisal  (10) 
Disto-la])io-ineisal  (11) 
Mesiodinguo-incisal  (12) 
Disto-liiiguo-incisal  ( 13) 

In  incisors  having  a  distinct  incisal  surface,  the  following 
line  angles  must  be  added. 

Line  Angles 
La])io-incisal  (14) 
Linguo-incisal  (15) 
Mesio-incisal  (16) 
Disto-incisal  (17) 

65 


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CAST    l;0L1)    AXD    POIK'ET.AIX    INLAYS 


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CAVITY    niEPAItATloX  (u 

'^riic  cuspids,  Upper  -Awd  lower,  pi-cscnl  I'oi'  cxaniiuatiou  four, 
aud  lart'ly  live,  disliud  suiTacos,  a  teariu;;'  i)()inl,  or  <'us]),  winch 
latter  is  soiuetiiucs  i-e])laced  hy  a  cuttiu;;'  ed^c  oi-  a  distinct 
iiK'isal,  or,  bettor,  prehensile  surface.     (See  Fi^-.  :!.) 

SnU'Aciis  OF  CrsiMDs 
Mesial  (1) 
Distal  (2) 
]jiii^-ual  (.''>) 
Jjahial   {4-),  soiuetiiues   hi-okeu 

l)y  the  labial  ridge  into 
fjabio-nu  sial  and  (5), 
Lal)io-distal  surfaces  (G) 

AxGLES  OF  Cuspids 
Line  Angles 
Mesio-lahial  (7) 
Mesio-liugual  (8) 
])istodiiioual  (9) 
Disto4abial    (10),   and   very   often  the   labial  angle    (11), 
formed  by  the  uiesio-lal)ial  and  disto-labial  surfaces,  and  when 
there  is  a  distinct  prehensile  surface,  there  are  the  line  angles 
of  the 

Lahio-prehensile  (12) 
Linguo-prehensile  (13) 
Mesio-prehensile  (14) 
Disto-j^rehensile  (IT)) 

Line  Angles 
]\[esio-lal)io-prehensile  (K)) 
Mesio-linguo-prehensile  (17) 
Disto-labio-jn-ehensile  (18) 
Disto-linguo-i^rehensile  (19), 
and,  at  the  cusj)  extremity,  the 
Lahio-linguo-prehensile    (20),  point   angle  formed  by  the 
labial,  the  lingual  surfaces,  and  the  prehensile  surface  of  tlie 
tooth.    And  when  the  labial  ridge  is  present  in  a  cuspid,  the  last 
named  point  angle  may  be  referred  to  as  tlu'  antero-labio-incisal, 
or  prehensile  (21 ),  and  post(M-o-la1)io-incisal,  or  prehensile,  angle 
of  the  cusx:^^  (22). 


(J8  CAST    COM)     \NI'     POIICKI.AIX     |.\I.A^•S 

With  tiic  apprin'aiicc  of  a  disliiict  iiicisal  oi-  jjrclicii^-ilc  sur- 
faces circuiiiscril)iii,L;'  the  pi-chciisilc  surface  for  its  entire  extent, 
the  ])rchensih'  s\i)-face  assumes  the  sliapc  of  an  ellipse,  line 
angles  only,  present  themselves,  and  we  lia\-e  the  mesial  and 
ilistal  arcs  t'orniod  by  the  mesial,  lahial,  lin,uTial,  and  distal  sur- 
faces eircumsci'ibin<;-  the  jDrelieusile  surface  for  its  entire  extent. 

The  bicuspids  and  molars  present  for  tlie  inlay  worker  live 
surfaces  as  folloAvs:     (See  Fi,^•.  4.) 

Sun  FACES  or  l>jcrspii).s 

Mesial  (1) 
Distal  (•2) 
Buccal  (13) 
Lingual  (-f) 
Occlusal  {7)) 

Tlie  occlusal  surfaces  of  the  bicuspids  and  molars  are  sub- 
divided into  twice  as  many  smaller  surfaces  as  tlie  cusi)ids  have 
ridges,  each  ridge  dividing  the  surface  of  the  cus])  ujjon  which 
it  presents  itself  into  two  surfaces;  the  number  of  line  angles 
and  jyo'iut  angles  i)res(Mit  in  these  teeth  is,  therefore,  corres])ond- 
ingly  increased. 

If  the  occlusal  surface  is  considered  as  an  intei'ru])ted  hoi'- 
izontal  sni-face,  the  line  angles  in  the  bicus2:)ids  and  molars  ai-e, 
according  to  Black  (who,  by  the  way,  treats  tliis  surface  only 
as  such),  as  follows: 

Angles  or  iJici'si'ins  and  MolaPuS 

Line  Angles 

Mesio-huccal  ((i) 
])isto-l)Uccal  (7) 
Mesio-lingual  (8) 
Disto-liiigual  (!)) 
Mesio-occlu>al  ( 10) 
])isto-ocelusal   (II) 
Bucco-occlusal   (12) 
ijinguo-occlusal  ( K!) 


C'AVITV    J'KKl'AUA'l  iOX  ()!' 

Point  An  files 

Mesio-l)iicco-occliisal  (14) 

Disto-bucco-occliisal  ( 1 .")) 

Mesio-liiift'iio-occhisal  (Hi) 

Disto-liii^iio-occlusal  (17) 
It  iiii,i;lit  1)('  well  to  rciiu  iiihci-  that  in  this  .ncoiiicti-ic  ft'oo^'ra- 
pliy,  we  ai-c  much  closer  to  s])herical  tliau  just  i)Uiiii  ^-eoinetry, 
and  so  the  refei-ence  to  eacli  surface  as  distinct  hy,  and  foi-,  it- 
self, and  llic  con-espondiiii;-  an<;le  (sui't'ace  angles)  need  not  l)e 
dwelt  upon. 

It  is  l)est  to  consider  tlie  suid'aces  of  these  teeth  as  iner^in^- 
into  one  another  ])resentinft'  no  liarsh  or  shar])  deviations  which 
are  always  weak  ])oints  ])otli  in  heauty  and  construction. 

The  exception  to  this  fore^oin*;-,  is  the  occlusal  surface  of 
tlie  posterior  teeth.  Here  tlie  division  of  this  surface  by  the 
various  ridges  jn'esentin"'  themselves  upon  their  respective 
cusps  nuist  he  distinct  and  well  detined,  ])roducinf;'  eminences, 
sulci,  and  fossa'  in  contradistinction  to  the  undulations  ])resent 
ui)on  the  other  surfaces  of  these  teeth. 

HYGIENIC  LANDMARKS  OF  THE  TEETH 

The  inlay  worker  must  consider  two  distinct  areas  in  each 
tooth: 

First:    Tlie  immune,  or  comparatively  inmiune,  area. 

Second:    Susceptible  area. 

The  innnune  area  of  a  tooth  is  that  pai't  of  it  which  is 
constantly  bein<;-  cleaned  and  kept  free  from  de))ris  by  incision, 
l)reliension,  mastication,  and  trituration,  or  )jy  the  action  of 
lips,  cheeks,  tongue  and  toothbrush. 

The  susceptiljle  areas  are  the  i)ortions  of  the  teeth  not  so 
cleaned;  in  other  woi'ds,  the  portions  inaccessihle  to  cleansing- 
friction  by  the  agents  named. 

Among  the  former,  or  comijaratively  innnune  areas,  may  be 
mentioned  the  lal)ial,  lingual,  and  incisal  surfaces  of  the  an- 
terior teeth:  the  buccal,  lingual,  and  the  welling  ])orti()ns  of  the 
occlusal  surfaces  of  the  j)osterior  teeth;  and,  in  mouths  free  from 
])athol()gically  inxaded  ahcoli,  the  gillgi^•al  and  subgingival  cir- 
cumference. 


70 


CAST    COLD    AXD    PORCELAIX    IXI.AYS 


To  the  siis(H'i)til)lt'  areas  l)elo]i,<;'  the  ])roxiiiial  surfaces  of  the 
teeth,  llie  distal  surfaces  of  the  last  molars,  and  the  gingival 
third  of  the  buccal  surfaces  of  the  last  molars;  the  deep  sulci, 
fosstp,  and  fissures  upon  the  occlusal  surfaces  of  the  posterior 
teeth;  the  deep  fissures  on  tlie  lingual  surfaces  of  anterior 
teeth;  and,  in  cases  subject  to  pathologic  invasion  of  the  alveoli, 
and  the  consequent  breaking  of  the  last  named  structure,  all 
gingival  and  subgingival  surfaces  open  to  contact  with  fer- 
mentation and  not  easily  dislodged  food  debris.  (Figs.  5,  6, 
and  7.) 


'      -2,    J 


\ 


Fig.  5. 


Fig.   6. 


Fig.  ~). — Sliiiwin^i  iiimuiiic  .'iifas  of  aiitcrioi'  tcctli  am!  Misi'('|itilile  areas.  Iiii- 
niiiiio  aroHs:  1,  Jahial  .surface; ;  2,  lingua!  .suifacf;  .'!,  iiicisal  sinfacf.  Susccjitihlo 
aroa.s:  4,  di.sto-proximal  surface;  5,  mesio-pioxiinal  surface;  (i,  ccivical  |i(irti(iii  of 
labial  surface. 

Fig.  n. —  Iiniiiuiic  ar.-as  of  jiostcrior  tcctli.  I,  '2,  '■'>,  t,  welling  |i(iiti<iiis  of  occlusal 
surface;   .I,  Imccal  .surface;   fi,  lingual  surface. 

Fig.  7. — Immune  areas  ami  suscoi)til)lo  areas  of  jxisterior  teeth.  Immune 
areas:  1,  liuccal  surface;  2,  lingual  surface;  .'!,  4,  5,  6,  welling  portions  of  occlusal 
surfaces.  Siiscejitilile  areas:  7,  mnsio-jtroximal  surface;  8,  (listoj)roxiinal  sur- 
face; ;»,  10,  n,  sulci  and  fissures  of  occlusal  surfaces.  12  and  1.;,  Imcco-  and  linguo- 
giiigival   areas;   sometimes   susceptilde,   often    ininuine. 


CAVi'r\-   iM;Ki>Ar.Ai-i<)X  <i 

Three  ;;reat  factors  enter  into  actual  ca\ity  j)rei)aration. 
Tlieyare: 

1.  The  surgical  or  o])erative,  wliicli  means  the  actual  cutting;' 
of  tooth  structure  (including  the  extir])ation  of  the  pulp,  tlie 
proper  treatment  and  filling  of  the  I'oot  canals). 

2.  The  mechanical,  or  foi-mative,  which  means  that  mode 
of  tooth  structure  cutting  which  hrings  it,  when  cut,  into  the 
field  of  physics,  geometry,  and  mathematics. 

0.  The  alterative  factor,  which  means  the  factor  tending  to 
])roduce  a  change  from  a  decre])it  oi-  al)normal  to  a  healthy  con- 
dition because  of  its  restoration  to  ])ro])er  jthysical  I'elation  to 
the  surrounding  tissues. 

A  cavity  prepared  for  the  reception  of  a  cast  gold  inlay, 
nuist  comply  with  the  following  recpurements : 

1.  It  must  offer  a  series  of  angles  and  surfaces  best  suited 
to  resist  stress  or  tendency  to  fracture  the  tooth. 

2.  It  must  present  margins  so  prepared  as  to  conserve  the 
enamel  structure  of  the  tooth  and  not  expose  it  to  injury  dur- 
ing stress  of  occlusion  and  mastication. 

3.  It  must  offer  a  ready  access  for  the  making  of  the  wax 
model  in  the  direct  method  or  for  the  taking  of  an  impression 
of  the  cavity  in  the  indirect  method. 

4.  It  must  offer  a  retentive  receptacle  and  support  to  the 
inlay. 

5.  It  must  otfer  a  series  of  angles  and  surfaces  best  suited 
to  resist  the  stress  of  tendency  to  dislodge  the  inlay. 

6.  It  must  present  margins  so  prepared  that  the  finished 
operation  will  conform  as  nearly  as  I30ssil)le  to  the  highest  con- 
cei:)tion  of  beauty  of  form. 

7.  It  nmst  present  a  form  for  the  rece])tion  of  the  inlay 
which  shall  bring  the  various  margins  into  areas  of  compara- 
tive immunities.  This  last  requirement  is  what  is  connnonly 
understood  as  extension  for  prevention,  and  the  necessity  for 
it  varies  witli  the  condition,  habits,  and  understanding  of  the 
patient,  and  to  a  limitcMl  extent  nmst  be  left  to  the  Judgment 
of  the  oj^erator. 

Root  canal  treatment  does  not  come  witliin  the  scope  of 
this  volume,  and,  since  the  canals  of  the  teeth  we  are  called  upon 
to  restore  or  rebuild  ])y  means  of  inlays,  ])1ay  a  very  imi)ortant 


72 


CAST    COT.D    AXI)    P(  )1K'I:LA  I  X     INI.AVS 


])art  ill  till'  ])fci);iiati()n  oT  tlu'  cavitv-,  tlir  rcailci-  will  please 
hear  in  mind  that  1  speak  ol'  canals  properly  treated  and  filled 
as  we  iindeistand  this  work  today.  For  eoinijrelieiisive,  though 
hy  no  means  linal,  information  on  the  subject,  the  student  is 
referred  to  the  wi-itinf;'s  of  such  men  as  Eliein,  C'allahan,  Otto- 
leiigui,  etc.,  whose  sj^leudid  and  careful  work  in  this  field,  lias 
l)eeii  of  iiKstimable  aid  to  the  iirofession. 

It  is  further  assumed  that  tlie  student  has  enjoyed  the  ad- 
vantage of  a  course  in  the  micr()sc()i)ic  study  of  the  structure 
of  the  tooth:  llial  he  un(h'i-slands  the  liistologx',  and  is  familiar 


'i 

m 

1 

mBBH 

c 

1 

r 

l^ 

0     < 

?' 

^ 

Fig.  8. — A  set  of  chisels  uscil   liy  the  nulii/jr  in  tnoth  stinicturc  cutting. 


will)  th<'  maiiiii'r  in  which  tin-  ciianicl  rods  arc  disposed  o\'cr  the 
crown  surl'aci's  of  the  1ee1h.  and  1hc  c()n'^i(h'ra1  ion  he  is  1o  gi\'e 
Ihis  factor,  when  cax'ity  ])rej)ai'ation  is  a11eni|)le(L 

For  the  nniiii1ia1e<h  Ihis  will  make  a  serious  hreak'  in  tlie 
s(f|neiice  ol'llii.v  xohihi".  hii(  the\,  in  fad,  shoiihi  nol  I'cad  liiis 
a1  alh  'flic  two  nKMilioneil  (h'parl  nient  >  of  lool  work  and  his- 
toh)gy  are  p;irt  of  1  he  enihryo  ol'  know  led  i^i-  which  he  who  won  Id 
practice  inlay  work,  nin>1    possos  hiniselfor. 

J*iei',-(»|j   Scharer,   or   \oyes,   on    the    liis1oloL;y   ol'  the   leetli, 


('.\^■|'^^■    i'i;i:i'.\i;.\'ri()X  I'.l 

\\\\\  ,i;i\('  the  stiidctil    a   mass  of  n'ci'N'   iicccssarN'  and   \'('i\v   pcr- 
liiictit  iiiroi-iiiation. 

Anion,!;'  llic  inst  i-unicnts  of  tlic  inlay  woi-kci-  must  be  iii- 
(•lu(l<'(l:  ('()inpi-(  licnsivc  set  of  cliiscls, — sti'ai<^lit,  ri^-lil  and  left, 
at  varying'  oWlusc  angles,  to  facilitate  cutting'  of  <;iiif;ival  areas; 
])ear-slia])(Ml  and  inverted  cone  l)ui'rs;  and  vai-ious  file-cut  inlay 
])urrs  foi-  sli-ai,i;hl  handj)iece  and  coiiti'a-an^le;  mandrils  foi- 
carryiii<;'  sand|)aj)i'r  discs  and  cai'hoi'undum  discs  for  both;  and 
most  important,  a  set  of  small  ^cm  stones  mounted  n])on  man- 
drils for  botli  liand|)i( ces,  and  a  vai'iety  of  sliajjes  to  till  every 
possible  reciuirement. 

Fissure  burrs,  ci'oss-cut  oi"  ])lain,  ])lu,ii,-slia])ed  and  ta])ei"(Ml, 
may  be  added  to  complete  tJie  sni'^ical  and  mechanical  abi'asive 
instrument  list  for  cavity  preparation. 

The  necessity  for  the  rn])ber  dam  and  clam))  is  manifest 
when  the  saliva  interferes  with  (dean,  ra])i(l  work. 

The  .general  rules  for  tooth  cuttin,ii,'  may  be  enumerated  as 
follows: 

All  ovei-han,L;in,i;'  enamel  walls  must  Ix'  removed  with  the 
properly  inclined  chisels,  drivini  by  direct  hand  pressnre  or  a 
leather  covered  metallic  mallet. 

The  oi)eninft'  of  cavities  innst  l)e  started  with  sharp  l)nrrs, 
])lu<;-sliaped  or  cross-cut  tajiered  fissure  burrs  of  the  smallest 
size  suitable. 

As  soon  as  the  cavity  is  large  enough  to  jjermit  the  nsing 
of  a  gem  stone,  the  use  of  steel  burrs  nuist  ])e  discontinued  and 
the  stones  sul)stituted. 

At  no  time  of  tlie  o])eration  shall  tlie  tooth  be  allowed  to 
lieat  up,  and  with  this  end  in  view,  all  stones  used  in  cavity 
cutting  are  lun  under  Avater. 

The  margins  are  chiseled  and  then  linished  witli  sandpaper 
and  cuttlefish  discs. 

A  cavity  in  a  tooth  can  not  be  jiroperly  prejjared  unless 
that  tooth  and  the  teeth  adjoining  it,  if  there  be  any,  liave  been 
thoroughly  cleansed  of  any  deposits  which  may  be  j)resent;  and 
if  the  cavity  extends  beneatli  the  boi'der  of  the  gingival  line,  un- 
less the  gum  has  ))een  carefully  but  effectually  displaced  from 
the  li(dd  of  o])eration. 

Scalers    for    the    remo\al    of    de])()sits    and    jjoi'te-polishei's. 


74 


CAST    (iOLD    AXn    rOllt'ELAlX    INIAYS 


carrxiiii;'  liiu'l}'  powcU'i'cil  ])iiini('c'  stone  or  sile'X,  ^\■ill  accoiiijjlisli 
the  first  ])art  of  the  oi)eratioii;  \\\\i\o  the  displaeeineiit  of  ^'uni 
tissue  is  readily  brought  about  by  packing  tlie  cavity  Avitli  soft- 
ened gutta-percha  l)ase  ijlate,  and  leaving  that  in  the  cavity  for 
a  few  days.  The  case  presenting  itself  again,  the  base  plate  is 
softened  l)y  means  of  warm  instruments  and  removed. 

A  compreJiensive  view  of  the  field  of  operation  will  aid  us 
in  dettrmiuing  just  what  instruments  we  shall  have  to  employ 
in  the  actual  preparation  of  the  cavity  we  are  about  to  l)egin. 

The  inlay  worker  recognizes  three  distinct  types  of  cavities; 
they  are,  tiic  simple,  the  compound,  and  the  complex. 


Yv'.  9. 


Fi"-.  10. 


Fiy.  !).— Cro.ss  HcctiDii  of  iiuilai-  lootli  iilust  I'atin^-  |irc]iar('il  cavily  and  bc\cl. 
1,  2,  3,  cavity  and  bevel;  4,  5,  (i,  arms  and  l)ody  of   pulp.     SinipU'  t-avify. 

Fig.  10. — Cro.ss  section  of  inolar  showing-  a  disto-occlusal  cavity.  1,  hcvol 
upon  occlusal  surface;  2,  inclined  plane  offeriiifi'  i)()werful  resistance  to  displace- 
ment; 3,  flat  poiti<:n  of  ;;iii^i\al  srat  ;  -I,  1m'\c1ci1  p<iilion  of  ^iii^ixal  scat,  (.'oin- 
poUnd   cavity. 


,\  simple  caN'itN'  is  one  wliidi  in\'(il\('s  but  one  snrt'ace  of  a 
1()i)1  li. 

TIhtc  ;ir<'  llic  -iiiiph'  labial,  llic  siniplc-lingiial,  and  siinple- 
occlusal,  or  inci>;il,  caxit  ics. 

.\  eoinponnd  ciixilN-  is  one  wliicli  involves  nioi'e  Ihan  one, 
and  ina\'  in\'oi\e  all  bnl  one,  snrl'acc   of  llie  loolli. 


CAVITY    I'KKrAltATlOX  i 0 

'^riicrc  ai-('  as  ('xam])los  of  coiiijjouikI  caNilies: 

1.  Tlic  iiiesio-occlusal 

-.  'I'lic  (listo-occliisal 

1).  The  in('si()-la))i()-o('('lnsal 

4.  The  disto-lahio-occlusal 

5.  The  niesio-hi))ial 
().  The  mesio-liiiftual 

7.  Tlie  tlisto-hil)ial 

8.  Tlie  disto-liii^ual 

9.  Tlie  lal)i()-oc'('liisal 

10.  The  liiiouo-occlusal 

11.  The  lahio-oecluso-liiigiial 

12.  The  mesio-occ'luso-distal,   or   what 

is  known  as  the  ]\[.  O.  1).  cavity. 

A  complex  cavity  is  one  that  takes  np  at  least  a  part  of 
every  surface  of  a  tootli,  and  as  an  example  may  ))e  mentioned, 

A  mesio-labio-lin<^uo-occlnso-distal  cavity. 

The  surgical  work  in  the  preparation  of  simple  cavities  con- 
sists, outside  of  root  treatment  and  elimination  of  impeding 
gum  tissue,  merely  in  the  laying  open  of  the  cavity  area  and  the 
chiseling  of  the  surrounding  walls. 

The  mechanical  or  formative  part  of  the  work  consists  in 
stoning  the  walls  and  floor  of  the  cavity  in  such  a  manner  that 
it  will  conform  in  curvature  to  the  curve  of  the  surface  upon 
which  it  is  j^resent. 

The  surrounding  walls  may  be  stoned  so  that  for  two-thirds 
of  their  deptli  they  shall  he  perjoendicular  to  the  cavo  surface, 
and  the  remaining  third  of  the  surrounding  walls  nearest  the  or- 
ifice of  the  cavity  may  deviate  from  the  jDerpendicular  and  di- 
verge to  form  an  angle  of  30  to  45  degrees. 

The  alterative  part  of  the  work  consists  in  so  completing 
the  prej^aration  that  it  will  present  a  sightly  and  pleasing  and 
lasting  result,  properly  protecting  the  enamel,  that  it  will  bring 
all  the  margins  into  areas  of  comparative  immunity,  and  thus 
pi'esent  a  restomtioii  most  acceptable  to  the  surrounding  tis- 
sues, and  hence  conducive  to  the  utmost  conservation  of  the 
tooth. 

In  com})oun(l  and  complex  cavities,  the  alterative  part  of 
the  preparation  concerns  itself  with  the  i)roi)er  amount  of  se])a- 


<()  CAST    (lol.D    ANIi    rollCl'.LAI  X     1XI.A\S 

ration  rcM|uii-iMl  (wlicii  any  is  rccjuiin  d ),  and  w  illi  tlic  restoration 
of  wliat  may  he  callccl  tin'  ncclnsaJ  Ixihiucc. 

AVe  must  ))ear  in  mind  tliat  the  occlusal  surface  of  tlie  ])()s- 
torior  teeth  serves,  not  only  in  the  function  of  mastication  and 
trituration,  but  hy  virtue  of  its  peculiar  formation  at  the  mesio- 
and  disto-oeclusar  lines,  respectively,  prevents  the  crowding'  of 
tlie  food  into  tlie  interdental  spaces  with  an  efficiency  in  propor- 
tion to  tlie  correct  formation  of  the  points  indicated.  In  other 
words,  the  occlusal  surfaces  of  these  teeth  has  more  than  one 
function;  that  of  mastication  and  trituration  of  food,  and  that 
of  the  prevention  of  the  crowding  of  food  into  the  interdental 
spaces. 

A  great  many  cases  of  so-called  pyorrhea  and  other  gin- 
gival lesions,  mav  he  traced  directly  to  poorly  executed  occlu- 
sal restoration;  and  when  we  realize  this,  Ave  shall  conclude  that 
these  surfaces  must  be  treated  with  as  great,  if  not  greater,  care 
than  any  othei-  tooth  surface  in  the  oral  cavity. 

A  poorly  ]-f stored  occlusal  surface  may  tlii'ow  the  entire 
face  out  of  balance,  and  so  become  the  cause  of  a  case  of  mal- 
occlusion, which  ma}'  entail  months  or  years  of  unremitting 
effort  to  correct. 

This  brings  us  face  to  face  with  the  realization  that  only 
l)y  means  of  the  cast  inla>'  is  a  pei'fc  ct  occlusal  restoration  pos- 
sible. 

CAVITY  PREPARATION 

The  <urgical  work'  in  the  ])re])a]'ation  of  the  eomponnd  and 
comj>lex  cavities,  consists  in  the  cleansing  of  the  held  of  ()])era- 
tion,  and  its  sui'roundings,  of  the  chiseling  away  of  the  ovei'- 
Inuiging  walls  in  sneli  a  inann(M-  that  no  niisn|)|)orte(l  enamel 
walls  he  lel't  standing. 

I'lie  margins  ai'e  so  prepared  thai  no  short  enaincd  I'ods 
present  any  feathei-  ('(jgc  for  thf  inln>-  to  I'rict  ionall\'  ])lay 
again>t.  H'  tin-  margin  of  deslrnelion  Icrininale-  in  a  (hep  sul- 
cus of  IIm-  occlnsal  sui'l'ace  of  a  tooth,  then  the  caNit)'  must  he 
<*xtend('(|  >i)  that  the  maigins  of  i1,  a1  llial  point,  are  cari-ied 
into,  and   Ix-yond   the  sulcus  onto   the  ascending   portion   of  the 


CAVrrv    I'llKI'AKA'I'lOX  it 

cusp.  Tlic  sulcus  is  then  r('|)|-()(luc(M|  In  llic  wax  inlay,  1o  he 
sul)S('([U('iil  ly  (luplicalcij  in  llic  uold. 

n'lu'  cuanicl  seal  of  the  inla\'  should  he  as  hroad  aud  cx- 
l(Misi\-('  as  j)()ssil)l(',  and  willi  that  cud  in  \ic\v,  llic  l)c\-cl  butt 
joint  is  used. 

In  tcclh  prcscutiu^-  a  li\"c  pul]),  the  location  of  tliis  or^-an 
must  more  oi-  less  dctcimiiic  the  extent  of  l)otli  sur^^icai  and 
mechanical  oi'  roi-malivc  work  to  he  done  on  and  in  the  cavity. 

AVheu  no  ])ulps  are  in'esent,  the  pulj)  canals  and  chamliei' 
must  co]ne  in  Tor  their  share  of  tlie  surgical  attention,  in  that 
the  former  are  i)roper]3'  hlled,  and  the  coronal  i:)art  so  cut  as 
to  form  Hat  and  variously  slantino-  substantial  seats  for  the  inlay. 

It  is  the  mechanical,  or  foi'mative,  part  of  the  woi'k  that 
comes  in  for  very  careful  attention  and  for  considerable  study. 
The  direction  of  the  stress,  which  the  joarticular  tooth  is  called 
u])on  to  withstand,  should  lar^'ely  determine  the  form  of  cavity 
which  we  shall  ])re])are  for  an  iiday.  As  a  broad  and  general 
rule,  the  following  may  be  considei-ed: 

The  frictionah  or  contact  relation  which  exists  between  a 
tooth  and  the  inlay  made  for  it,  should  be,  at  least  half  again 
as  large  as  that  part  of  the  iiday  which  will  be  called  upon  to 
enter  into  stress  relation  with  the  oj)])osing  teeth  and  surround- 
ing tissues. 

This  applies  to  all  cavities  and  most  particularly  to  com- 
j)Ound  and  complex  cavities,  and  in  these  latter  cavities,  the 
rule  luay  be  elucidated  as  follows:  the  more  of  an  inlay  inside 
the  tooth,  and  the  less  of  an  inlay  outside  the  tooth,  the  less 
chance  for  sui-gical  or  mechanical  injury  to  that  tooth. 

Please  note  the  his'ide  of  the  tooth  and  outside  of  the  tooth, 
and  do  not  confuse  with  on  or  (diore  the  tooth.  An  inlay  may 
be  made  for  a  tooth,  aud  it  may  present  or  restore  the  entire 
occlusal  surface  of  that  tooth,  and  so  ex^wse  a  very  extensive 
area  to  stress  relation  with  the  opposing  teeth,  and  the  area 
of  frictional  relation  between  this  cavity  and  this  inlay  may 
seem  to  be  smaller  in  extent  than  the  area  exjiosed  to  stress. 
These  inlays  must  be  considered  as  resting  in  a  box  seat;  in 
other  words,  the  cavity  is  one  presenting  the  apix'arance  of  a 
simple  one  in  every  surface  but  the  floor;  here  is  found  a  devia- 
tit)n  in  that  floor,  instead  of  conforming  in  shape  to  the  sur- 


78 


CAST    (lOLI)    AXl)    PORCEI.AIX    IXLAYS 


face  111)011  wliicli  it  presents,  slopes  to  l)eeoiiie  an  inclined  plane 
to  offer  the  reqnired  resistance  to  displacement  dnriiio-  stress 
of  mastication.  The  incline  slionld  be  sharp  and  well  defined; 
a  step  may  ])e  nsed,  hnt  an  incline  tends  to  l)etter  conservation 
of  the  tooth. 

In  teeth  snl)ject  to  stress,  from  and  in  more  than  one  di- 
rection, these  lines  of  stress  must  be  carefully  studied,  and  an 
inclined  plane  must  be  formed  upon  the  floor  of  the  cavity  to 
o])i)ose  each  line  of  direction  of  stress. 

In  cases  where  the  cusps  are  very  deep,  and  where  the  man- 
(lil)le  enjoys  a  limited  laterorotary  motion,  thus  subjecting  the 
molar  teeth  to  a  considerably  greater  amount  of  laterorotary 
stress  than  Avould  be  the  case  if  the  motion  of  the  mandible  were 


Fig.  11. 


Fiff.  12. 


Fig.  11. — Longitudinal  .section  of  molar,  at  1  and  2,  jncsial  and  distal  planes, 
re.spoetivoly,  witli  apex  at  ?>.  Note  correspondence  of  incline  in  planes  and 
bevels  at  4  and  5.     Planes  and  bevels  are  practical!  parallel.     Complex  cavity. 

Fig.  12. — Cross  section  of  bicuspid  showing  (1)  occluso-disto-lingual  plane 
and    (2)   occluso-mesio-lniccal    pliiiic     Complex  cavity. 

very  free  in  lliaf  dii'cciioii,  the  Door  of  iln  sc  cavities  should  i)re- 
sent  four  distinct  ])lanes,  and,  foi-  convenience,  may  be  desig- 
nated as:  the  mesial  plane;  the  distal  jjlane;  the  lingual  or 
palatal  plane;  and  the  buccal  plane.  The  highest  point  of  the 
flof)r  of  the  cavity  may  be  called  the  apex;  and  these  planes  will 
coi-i'es])oiid,  ()]■  should,  as  neai'ly  as  possible,  corres])ond,  in  })itch 
or  angles  to  the  })lane  presenting  as  a  bevel  n])on  surface  of 
the  cavity,  to-wit:  mesio-occlusal;  disto-occliisal ;  bucco-occlusal ; 
linguo-occlusah     Thus  if  tlic  cxfcnl   of  Ihc  ai-ca  of  the  iiih-iy  in 


('A\i'r\    niiicAKA'i'iox  7f) 

ri-i('ii()ii;il  I'ch'ilioii  with  llic  (';i\ii>'  of  llic  tooth  he  (•ai'(^fully  cx- 
amiiKMl,  it  w  III  he  round  to  cxcccil  the  ai'ca  of  the  inlay  in  stress 
I'clation  with  the  ()i)])()sin^-  teeth  and  sun-oundiii*;'  tissues. 

In  molar  teeth  and  hieusjiids,  which  ai'e  unusually  small, 
and  in  which  restoi'ations  of  this  chai'acter  are  uecessary,  the 
preparation  of  tiiese  ])lanes  nia\'  he  so  Aaried  tliat  only  two 
instead  ol'  four  planes  are  made,  and  in  these  cases,  the  hi<;'li- 
est  ])art  of  tlie  (looi-  shall  l)e  a  dia^'onal  line  fi'om  the  disto-])Uccal 
to  inesio-lin<;ual,  or  the  distodin^'ual  to  tlie  mesio-huccal  angle 
ol'  tlie  tooth,  respectively;  thei-e  will  he  the 

()ccluso-disto-lin<;ual  i)lane,  and  the 
Occluso-mesio-buccal  ]:)lane. 

With  a  view  to  greater  i-esi stance  to  fracture  of  the  tooth, 
and  to  displacement  of  the  iulay,  planes  are  hy  far  to  he  pre- 
ferred to  suj^i^lemental  pins,  except  when  these  pins  can  he 
])laced  into  the  pulj)  cluuiilier,  or  canals,  and  even  then,  a  multi- 
plicity of  these  supplemental  ])ins  would  needlessly  complicate 
the  preparation,  in  that  the  holes  to  receive  tliem  would  neces- 
sarily have  to  he  parallel  to  all  vertical  walls  of  the  cavity  and 
to  each  other. 

In  vital  teeth  these  pins  should  he  looked  upon  as  a  means 
of  last  resource,  and,  when  used  at  all,  they  should  he  as  stout 
as  the  hulk  of  the  tooth  structures  in  that  locality  will  allow; 
they  should  enter  the  tooth  structure  to  a  depth  equal  to  at  least 
half  of  tln^ir  circumference  and  no  gi'eater  than  their  circum- 
ference. 

For  molar  teeth  a  15-  or  Kvgauge  iridio-platinum  wire  is 
used  and  for  bicuspids  a  17-  or  18-  or  even  20-gauge  wire  will 
suflfice. 

There  should  he  at  least  15  per  cent  iridium  in  the  platinum, 
and  it  may  be  threaded  in  two  or  three  inch  lengths  and  cut  into 
small  pieces  equal  in  length  to  the  circumference  of  the  wire. 

These  pieces  are  coated  to  half  their  length  with  graphite 
or  whiting,  and  a  small  piece  of  pure  gold  is  wrapped  around 
the  other  half  and  joined  to  it  with  the  Idowpipe.  This  pre- 
caution will  insure  the  picking  of  these  wires  when  the  inlay 
is  cast,  and  will  also  insure  a  perfect  union  between  the  gold 
of  the  inlay  and  these  wires. 


80 


CASI'    COLD    AXI)    I'OltCKI.AlX     IXJ.AVS 


FijT.   13. 


1^^ 


□ 


Fiti.  14. 


Fi2:-  15. 


E] 


vi-r  ]<; 


Fiii-.  i; 


CAVITY   im;ki'ai;ati()X 


81 


Five  Views  of  ax  Upper  First  Bicuspid  Fresextixg  a 
Simple  Occlvsal  ('a\ity,  axd  tjie  Cast  Gold  Ixlav  Made  foi:  It. 

Fi<i'.  Kk — A  view  of  the  cavity.  Xoto  the  depth  and  tlie  1)evel 
on  the  occliLsal  third  of  the  depth. 

Fig.  14. — Occlusal  view  of  the  carved  inlay.  Xoto  the  trans- 
veise   groove   and  the   marginal  ridges. 

Fig.  15. — A  cavo-surfacc  view  of  the  inlay.  Xnto  the  wcU- 
dcfined  outlines  and  the  bevel. 

Figs.  16  and  17. — Views  of  the  finislied  operation.  Xote  the 
extension  of  the  margin.s  to  the  ascending  portions  of  tlie  cusps 
jind  nuiiginal  lidges. 

Stress  Index:  Upward,  out  and  backward,  in  and  foiwaiil  or 
intraalrcoJar,  Labio-Dlstally  and  Lixguo-Mesially. 


82  CAST    GOLD    AXD    PORCELATX    IXLAYS 


Fig.  18.  Fig.    19.  Fig.    20. 


Fig.  21. 


□  SO 

Fig.    22.  Fig.    2;i.  Fig.    24. 


CAVITY    PRErATtATlOX  83 


Seven  Views  of  a  First  Bight  Lower  Bicuspid  Present- 
ing A  Compound  Disto-Occlusal  Caviiy  Involving  also  the 
Cervical  Portion  of  the  Buccal  Wall,  Eestoreu  with  a  Cast 
Gold  Inlay   Disto-Occlusally,   and  a  Porcelain   Inlay   Buc- 

CALLY. 

Fig.  18. — A  view  of  the  cavity.  Note  tlie  well -defined  step 
with  its  intdined  plane  running  mesial ly,  the  well-defined  gingival 
seat  with  its  Ijevel,  the  broad,  well-beveled  enamel  margins  ling- 
ually,  buecally,  and  oi-tdu.STlly. 

Fig.  19. — A  view  of  the  cervical  cavity  pre^jared  for  the  x)or- 
celain  inlay.  Note  the  bevel  of  the  external  third  of  the  cavity 
walls  and  note  how  the  floor  of  the  cavity  conforms  to  the  wall 
of  the  tooth  upon  which  it  presents. 

Fig.  20. — An  occlusal  view  of  the  disto-occlusal  ca\dty.  Xote 
the  bevel  of  the  margins  hero, — how  they  have  been  carried  to  the 
immune  areas. 

Figs.  21  and  22. — Views  of  the  inlay.  Xote  in  Fig.  19  the 
carving  upon  the  occlusal  surface,  and  in  Fig  20,  the  well-balanced 
retentive  form  and  seat  of  the  inlay. 

Fig.  23. — A  view  of  the  finished  inlays  in  position.  Note  the 
operation  carried  into  the  area  of  immunity  Imccally. 

Fig.  24. — A  disto-bucco-linguo-occlusal  view  of  the  finished 
o^jeration.  Xote  here  the  lingual  part  of  the  operation  carried 
into  the  area  of  comparative  immunity. 

The  gold  inlay  for  the  restoration  of  the  disto-oeclusal  part 
of  the  tooth  is  comjjleted  and  forms  the  disto-buccal  angle  of 
the  cavity*  for  the  porcelain  inlay. 

Stress  Index:  Down  and  inward,  down  and  liackward  and 
down  and  forward  or  Intralingually,^  intradistaUy-  and  intra- 
viesially.* 


*IiitraaIvfolar. 


^-t 


CAST    (iOlJ)    AND    roiH'KLAlX     IXLAVS 


O0 


Fi"-.  25. 


Fi-.  2i\. 


Fig-.  27. 


Fi"-.  2S. 


Fvy.  211. 


In    ^        ii^.^ 


Fig.  :!... 


FiK.  :ii. 


i''ii 


('.\\rr\'    i'i;i',i'.\!;.\'ri().\  8."3 


Eight  Views  or  ax  Uppek  First  Bicuspiu  Pkesextixg  .\ 
Mesio-Occlusal  Cavitv,  axd  the  Restokatiox  Made  for  It. 

Figs.  25,  26,  and  27. — Different  view.s  of  the  c-avity.  They 
explain  themselves. 

Figs.   28  and   20. —  \'i(>ws  of  the  gold    inlay. 

Figs.  30,  31,  and  32. — .Showing  the  linisheil  o[ieration,  and 
liow  the  mesial  portion  of  the  gold  inlay  may  lie  replaced  'with 
porcelain. 

Stress  Index:  Upward,  out  am!  backward  and  in  and  for- 
ward  or  Ixtraalveolar,   lahio-distalli)   and   Unffuo-mesiaUij. 


86 


CAST    COLD    AND    PORCELAIX    JXLAVS 


Fiff.  33. 


Fiff.  34. 


Fiff.  35. 


Fig.  3G. 


Fiff.  37. 


CAVITY    niEPATlATION  87 


Five  Views  of  a  Lower  Second  Bicuspid  Presexting  a 
Mesio-Disto-Occlusal  Cavity,  and  the  Inlay  Made  for  It. 

Fig.  33. — A  view  of  the  cavity.  Note  its  well-defined  step, 
the  beveled  gingival  seat,  the  beveled  enamel  margins.  Note  the 
whole  operation  carried  into  areas  of  comparative  immunity.  Note 
the  incline  of  the  occlusal  siirface  of  the  cavity  so  that  it  forms 
an  acute  angle  with  the   distal  wall. 

Figs.   34  and   35. — Occlusal  and   mesial  views   of  the   cavity. 

Figs.  36  and  37. — Views  of  the  inh\y.  Note  in  Fig.  36  the 
definition  of  every  part  of  the  inlay,  and  in  Fig.  37,  the  occlusal 
restoration  anatomically  conect.  Note  the  lingual  cusps  and  the 
well-defined  marginal  ridges. 

Stress  Index:  Down  and  inward,  down  and  liackward,  down 
and  forward,  or  Intralixgually,  intradistdlly  and  intramesially. 


8S 


CAS'r    OOl.l)    AXD    P()i;('l'",l,AIX     IXI.AYS 


Fi-.  MS. 


F'ux.  MS). 


Fio-.  4(1. 


□  □ 


Fi-r.  41. 


Fip-.  42. 


Fie.  43. 


UU 


I'ii;.  44. 


Fig.  40. 


Fie.  4ii 


c.wi'iN    n:i:i'Ai;.\'i'i()X  S9 


Nine  Views  of  a  Me.sio-Occlu.SxVf,  Cavity  i\  a  First  Lowku 
Bicuspid,  and  Eestoration  Made  for  It. 

A   Cast   Gold    Jxlav,   the   MESio-LixfiUAL  Part   of   It.   ix 

TrKX,    IXLAVEL)    AVITII     .SVXTIIF.TIC    PORCELAIN. 

Fi^s.  ;J8,  :!9,  and  40.— Views  of  tlio  c-avitv.  Note  the  licvcl- 
iiiy  of  tlie  walls,  iiuirgins,  scat,  etc.  Note  the  acute  anylc  foniieil 
by  the  occlusal   and   mesial   surfaces   of  the  cavity. 

Fig.   41. — A   niesio-occlusal   view   of   inlay. 

Fig.   42. — A   cavo-surfacc^  view  of   inlay. 

Figs.  43  and  44. — Occlusal  views  of  finished  operation.  Note 
how  the  margins  of  the  inlay  are  carried  to  the  ascending  portions 
of  cusp  and  sulci  of  the  tooth. 

Figs.  45  and  46. — Mesiodingual  and  mesiodjuccal  views  of 
the  finished  operation  carried  into  areas  of  comparative  immunity. 
Note  in  Fig.  46  the  outline  of  the  porcelain  insert. 

Stre:--s  Index:  Down  and  inward,  down  and  backward,  down 
and   f(M\v;ird,   or  Ixtkalixclally,   int I'odi.sialhj  and    i iiIvidik .sialli/. 


90 


CAST    GOLD    AXD    PORt'ELAIX    INLAYS 


Fig.  47. 


Fig.  48. 


Fiff.  49. 


^^ 


Fig.  50. 


Fig.  51. 


Fig.  oii. 


Fie.  So. 


Fig.  54. 


^AVIT^■  rr.KPAiiATiDX  1)1 


Eight  Views  of  a  Lower  Second  Bicuspid  Presenting  a 
MESio-DiSTo-OccLrsAL  Cavity,  and  the  Eestoration  Made  for 
It. 

A  Cast  Gold  Inlay,  the  Mesio-Buccal  and  Disto-Buccal 
Parts  of  It,  in  Turn,  Inlayed  with  Synthetic  Porcelain. 

Figs.  47,  48,  and  49. — Viows  of  Cavity  sliowing  bevels,  seats, 
and  tapei',  also  occluso-disto-linyual  ])lar.e  and  occluso-mesio-buc- 
cal  plane. 

Fig.  50. — Occlusal  view  of  inlay. 

Fig.  51. — Cavo-surface  view  of  inlay.  Note  reproduction  of 
jdanes. 

Fig.  52. — Occlusal  view  of  inlay  in  position.  Note  the  caiiy- 
ing  of  the  margins  of  the  inlay  to  the  ascending  portions  of  the 
cusps  and   sulci.     Note  reproduction   of  marginal   ridges. 

Figs  53  and  54. — A'iews  of  inlay  with  synthetic  insert  in 
position  on  the  tooth.  Note  the  carrying  of  the  restoration  into 
areas  of  comparative  immunity. 

Stress  Index:  Down  and  inward,  down  and  liackward,  down 
and  forward  or  Intralingually,  intradistaUy  and  intramcsially. 


92 


CAST    COLD    AX  1 1     I'OIU  ICl.AI  X     1X1>A^■S 


Fig.   55. 


Fie-.  56. 


Fig.  57. 


Fiff.  58. 


Fig.  59. 


Fi-.   CI). 


c.wri'N    im:i;i'.\i;ati().\' 


d;; 


A  First  Lower  Molar  Prksextixg  a  Labio-  or  Bucco-Oc- 
CLUSAL  Cavity,  and  the  Cast  Gold  Jxi.av  Made  for  It. 

Fig  .j5. — A'iew  of  the  prepared  cavity.  Xote  lievel  upon  nc- 
eliLsal  surface  carried  to  the  ascending-  portions  of  all  cusps.  Xote 
acute  anglo  formed  by  the  floor  and  buccal  wall  of  the  cavity. 

Fig.  56. — A  clearer  view  of  tlie  buccal  surface  and  the  taper 
and  bevel. 

Fig.  57. — A  view  of  the  carved  inlay. 

Fig.    58. — A   cavo-surface   view   of   the   inlay. 

Figs.  59  and  60. — View  of  the  finished  operation. 

Stress  Index:  Downward,  down  ar.d  outward,  down  in  and 
forward,  down,  back  and  inward,  ilown.  fore  and  outwaid  or 
Ixtraalveolar,  introbucco-dislaJIfi.  iiifraii ntimi  'msiallii.  intra- 
distodingually  and  intraniosio-buccally. 


9-1: 


CAST    (iOLD    AND    PORCELAIN    I^^LAYS 


Fio-.  01. 


Fig.   62. 


Fig.  63. 


Fio-.  r,4. 


Fi2-.  65. 


Fijj.  0(5. 


Fiff.  67. 


Fig.  68. 


CAVITY  pr.i;!'Ai;ATi()X  95 


A  Lower  Molar  Presenting  a  Disto-Occlusal  Cavity,  the 
Lower  Half  of  the  Buccal  Wall  Being  Involved  to  the  Full 
Mesio-Distal  Extent. 

Figs.  61,  62,  and  6.3. — Views  of  the  cavity. 

Figs.  64  and  65. — Views  of  the  disto-ocelusal  inlay  made  for 
the  cavity. 

Figs.  66,  67,  and  68. — Showing  the  finished  operation,  the 
buccal  surface  having  been  restored  with  a  porcelain  insert. 

The  disto-occlusal  restoration  was  first  made  and  cemented, 
til  us  leaving  a  simple  cavity  on  the  buccal  surface. 

Stress  Index:  Downward,  down  and  outward,  down  in  and 
forward,  down,  back  and  inward,  down,  fore  and  outward  or  In- 
tra alveolar,  in1  rahncco-distnlhi ,  intralinguo-mcsially ,  intradisto- 
lingualiv  and   intramesio-buccallv. 


J)(i 


CAST    (lOlJ)    AXI>    roiU'Kl.AlX     l^•lA^■s 


nan 


Fi-.  09. 


Fio-.   70. 


Fio-.   71. 


Fii 


□ 


Fio-.  74. 


Fio-.  7: 


Fiir.  71; 


Ki-.   77. 


Fio-.  78. 


CAVITY    PREPATIATIOX  97 


A  DiSTO-OCCLUSAL  CaVITY  IN   AX   UPPER    MOLAI{   AXl)  A   DlSTO- 

BuccAL  Cavity  in  the  SAjrE  Tooth. 

Two  Cast  Gold  Inlays  for  the  Eespective  Cavities  and 
Three  Views  ok  the  Finished  Operations. 

Fig.  69. — A  view  of  the  disto-lniccal  cavity.  Xote  the  bevel 
of  tlie  external  third  of  the  walls  aiul  the  cunformity  of  the  fioor 
to  the  wall  of  tlio  tooth  upon  which  the  cavity  presents. 

Figs.  70  and  71. — Vi;'\vs  of  the  disto-oeclusai  cavity.  Xote 
the  acute  angle  formed  liy  the  distal  and  occlusal  surfaces.  X^ote 
the  bevels  and  gingival  seat,  also  the  taper  of  the  cavity. 

Figs.  T'l  and  73. — Occlusal  and  cavo-surface  \ie\vs  of  the 
finished  inlay  for  the  disto-occlusal  jxirtion  of  the  tooth. 

Figs.  74  and  7-3. — Buccal  and  cavo-sujface  views  of  the  disto- 
buccal   inlay. 

Figs.  76,  77,  and  78. — Views  of  the  finisiied  operations.  Xote 
areas  of  immunity  into  which  the  operations  have  b?en  carried. 

Stress  Index :  Upward,  out  and  backward,  back  and  inward, 
fore  and   outward   or  Intraalveolar   Bucco-Distally  (listo-paUi- 

IdUjl  and  nusin-hiiccdJJi/  or  in  a  latero-rotarv  direction. 


5)8 


C'AS'I'    col. I)    AXn     I'OIU'I'.I.AIX     INLAWS 


Fio.    7ii. 


Fia-.  SO. 


Fio-.   81. 


Fi-.  n2. 


Fig.  s;]. 


SO 


Fi'r.    SI. 


Fi-    S.J 


Fig.   Si;. 


<^\vr^^•    I'ltKi'AitATiox  <)!) 


A  Mesio-Djsto-Occlusal  ('avitv  ix  ax  Ti-pek  ^Molai;,  also 
A  Buccal  Cavity  ix  the  SAJri;  Tooth. 

Fig.  79— Viow  of  tlic  1. ureal  cavity.  Note  licvd  and  con- 
formity of  surface. 

Fi.l;-.  !S(). — \'ic\v  of  occlusa!  surface  of  cavity,  also  slunviiig 
mesial  and   distal  ]iarts   of  it. 

Fig.  81. — Distal  poition  of  cavity  showing  also  the  occlusal 
planes.     Note  bevels  of  all  surfaces  and  taper  of  cavity  as  whole. 

Figs.  8:2  and  «;!. — Occlusal  and  cavo-surface  views  of  finished 
inlay.  Xotc  definition  of  occlusal  carving  in  Fig.  82,  ami  defini- 
tion of  cavo-surface  in   Fig.  8.3. 

Fig.  84. — Finishrd  operation  upon  l)uccal  suiface. 

Fig.  85. — Occlusal  view  of  finished  operation  of  mesio-disto- 
occlu.sal  inlay. 

Fig.  8(5. — View  of  distal  surface  of  completed  operation.  Xotc 
areas  of  immunity  into  which  the  whole  operation  lias  lieen  car- 
ried. 

Stress  Index:  Upward,  out  and  liaciiwaid,  hack  and  inward, 
fore  and  outward  or  Ixtkaalveolak  Bucco-Dihtally  (lislo-ixihi- 
iallil  ajul  mesio-haccalJ y  or  in  a  latero-rotarv  diiection. 


100 


CAST    GOLD    AXD    PORCELAIN    IXLAYS 


Fig.  87. 


Fig.  SS. 


CAV1T^"    IMtKPAltATlOX  101 


Figs.  87  and  88. — Two  illustrations  of  teeth  worn  down  l)y 
attrition,  restored  by  nipans  of  the  cast  gold  inlay,  imitating  the 
conditions  of  adjacent  teeth.      (Dr.  E.  Ottolengui.) 

Note  the  well-defined  carving  upon  the  occlusal  surfaces  and 
acquaint  yourself  with  the  fact  that  definition  does  not  necessa- 
lily  mean  deptli. 


101' 


CAST    (iOI.D    AND    rolH'KI  .A  I  X     INI.AN' 


y      1 


Fig.  S9. 


Fia-.  90. 


Fig.  91. 


Fig.  92. 


Fi'r    <j:i. 


Fi-    91. 


('A\  ^|■^    i'i;i:i'Ai:A'ri<)X 


103 


Lkft  Fiust  Lower  ^foi.AK  rKi:si:.\Tix(i  Defjciexcv  of  Oc- 
f'u:,SAL  Third.  Views  Ilmstkatixo  Freparatiox  of  Cavity  and 
Restoration'  Made  for  It  ix   iiie  Shape  of  a  Cast  Cold  Ixeav. 

Fig.  89. — Occliisiil  view  of  the  ciivity.  Xntc  llic  bevels  pre- 
s:'iitino-  around  the  jiei  i]ilie:v  et'  the  tooth  ami  at  the  circumfor- 
ciice  of  the  cavity.  The  extent  of  the  mitei  or  i>eri|jlieral  Level  is 
ofliial  to  one-half  the  depth  of  the  eavity  at  its  deepest  part. 
Xote  the  four  distinct  ]ilar,eH,  to  wit:  'i'he  mesial  i)la]ic,  the 
distal  Jilane,  tlie  lini;ual  plane,  and  the  liu.-ral  ]ihine.  Xote  also 
the    apex. 

Fig.  90. — A  liiK-eal  \  iew  of  the  cavity  showing  the  apex  of 
the  four  planes  to  be  somewhat  below  the  surface  of  tli:'  cavo- 
peripheral  bevel. 

Fig.   91. — Occlusal    view   <<\'   the  carved   inlay. 

Fig.  92. — Cavo-surface  view  of  the  inlay.  Xote  the  amount 
of  frictional  contact  between  inlay  and  tooth  gained  by  this 
four-planed  preparation  of  the  floor  of  the  cavity. 

Figs.  9.'!  and  94. — ^■ie\vs  of  the  iinished  operation,  a  power- 
ful and  lasting  restoration. 

Stress  Index:  Downward,  down  and  outward,  down  in  and 
forward,  down  back  and  inward,  down  fore  and  outward  or 
I.VTRAALVEOLAR,  iniriihucco-disifiJhi .  ill! niliiun'o-iiK  ■-:i(iUii.  intra- 
(lis-to-liiif/KaJlji,  (111(1  infraiiu .sid-biiccdlhi. 


104 


CAST    COLD    AND    rORCEr.AlX    IXLAVS 


Fio-.  95. 


Fia-.  9G. 


FiR-.  97. 


Fig.  98. 


Fig.  99. 


Fig.  100. 


i'i-.    Kil. 


Fio-.   11)1 


t'AVlTV    PREPAKAIIOX  Kj.j 


A  Complex  Cavitv  ix  ax  Uppkk  Molar  Ixvolvlvo  Every 
Surface  of  the  Tootil 

A  Cast  Gold  Inlay  Made  to  Kestoke  the  Tooth  to  Use 

AND    AXATOJriC    ACCEPTABLEXESS. 

Fig.  95. — A  view  of  the  occlusal  proparation  of  the  cavity. 
Note  the  occluso-disto-lingual  plane  and  the  occluso-mesio-buccal 
plane. 

Fig.  9(5. — A  general  view  of  the  cavity.  Note  tlie  well-sup- 
ported enamel,  the  beveled  margins  practically  continuous,  the 
well-defined  steps,  and  the  general  tape;-  of  the  whole  cavity  as 
shown  in  Figs.  96  and  97. 

Fig.  98. — A  view  of  tlic  occlusal  surface  of  tlie  carved  inlay. 

Fig.  99. — A  cavo-surface  view  of  tlie  carved  inlay. 

Fig.   100. — An  occlusal  view  of  tlie  inlay  in  position. 

Fig.  101. — A  buccal  view  of  tlie  restoration  showing  how  a 
synthetic  insert  may  be  made  for  this  surface. 

Fig.   102. — A   disto-palatal   view  of  the  finisiicd   operation. 

Stress  Index:  Upward,  out  and  l)ackward,  back  and  inward, 
fore  and  outward  or  Intraalveolar,  Bucco-Dlstally,  disto-pal- 
ataUy  and  mcsio-hiiccally  or  in  a  latero-rotarv  direction. 


lOG 


CAST  coLn  AM)   I'oitriOLAix    l^■|.A^■s 


Fio-.    i(i;;. 


Fie-.   104. 


Fig.  105. 


Fig.  106. 


Fig.  107. 


Fio-.  108. 


Fitr.  jo'j. 


Fi"-.  110. 


Fio-.   ]]!. 


c'A\  l'r^    i'i;i;i'.\i;a  rio.x  107 


\i.\K    \'ii;\\s    OK    A    Skiom)    I.owkk    Molak    Pke.senti.\(;    a 

.MhsIO-DiSTO-OcCLISO   lUCCAI.      (JAVITY       AXl)      TwO      iNTERIiOCKIXG 

Cast  Gold  Ixlavs  ^Iadf,  for  It. 

Fij;.  in.'i. — \'ic\v  (if  til.'  (ici-luMil  sihI'mcc  incpiinMl  t(i  jiic-ciit 
tin'  |il;iii;s  fur  aililnl  f rirtioiial  rclatinii  ln'twccn  inlay  ami  tintli. 
Xdtc    licvi'ls    jiicsciitiiiii'    in    all    niaii;ins. 

V\ix.  1(14. — View  of  distal  ]iart  of  (•a\ity.  Xoto  step,  lir\cls, 
s  at,   and   ta[ii'i-. 

Fii;.  lO.j. — JUK'cal  \ir\v.  Xutc  Ik'vl'Is  of  outci-  tliird  of 
cavity. 

Fig'.  10(i. — Occlusal  ^•il■\v  of  nicsio-ilis-to-occlusto  pnition  of 
inlay.     Note  the  lnckini;  dcxicc  in  it  liucco-occlusally. 

Fig'.  107. — Cavo-sui'fac;'  \it'\v  df  tho  Imccal  |i<jrtion  of  the 
inlay.  Note  Level  and  lock  to  tit  into  tli'  part  rcpi-cscntcd  by 
Fig."  106. 

Fig'.  108. — Cavo-sni'facc  \  icw  of   Fig.    KKi. 

Figs.  109,  llil,  and  111. — Views  of  the  tinislied  operation; 
ill  scipK'iice,  a  hnccal  \'i:'\v,  a  mesioduu-cal  \ie\v  and  an  occhiso- 
huccal   \i('\v. 

The  inesio-disto-occlu.sal  portion  of  tins  lestoration  i.s  finished 
first  and  cemented  into  position,  thus  making  a  l)iiceo-oeelusal  cav- 
ity to  lie  considered  for  the  second  operrition. 

Stress  Index:  Downward,  down  and  outward,  dnwn  in  and 
forward,  down  back  and  inward,  down  fore  ami  outwai-d  oi-  Ixtka- 
AiA'KOLAK,  intnihiicco-disidlly,  intraUnriuo-mrsiaUy,  intradistodin- 
gnallv   anil    intranic.-iodiuccallv. 


108 


CAST    CdLH    AND    TORCELAIX    JNLAYS 


Fie-.   112. 


Fiff.   113. 


Fia-.  114. 


Fie.  115. 


Fio-.   11(3. 


Firr.   117. 


Fig.  118. 


Fiti-.  11 U. 


{•AVI'I'N      i'lIKI'AI'.ATIOX 


109 


A  Mesio-Disto-Occluso-Palatal  Cavity  ix  an  Upper  Molar 
Restored  by  Means  of  a  Cast  Gold  Inlay. 

Pio-.  112. — A  view  of  the  palatal  surface  of  the  tootli.  Note 
the  Itevel  on  this  part  of  the  cavity  walls. 

Fi^-.  ll.j. — A  view  of  the  distal  part  of  the  cavity.  Note 
the  well-defined  step,  the  hiiceal  and  lingual  guides  where  the  inlay 
part  terminates  and  the  onlay  part  begins.  Note  the  taper  of  the 
cavity,  the  bevel  of  the  gingival  seat  and  other  margins. 

Fig.  114. — A  view  of  the  occlusal  surface  and  its  planes. 
Note  the  bevel  presenting  upon  this  surface. 

Fig.   115. — Oeclu.'ial  view   of  the  carved  inlay. 

Fig.  IKi. — (Javo-surfaci'  \-ic\\s  of  the  car\H'd   inlay. 

Figs.  117,  118,  and  119. — Views  of  the  finished  operation. 
Note  the  well-defined  occlusal  restoration,  the  restored  bell  shajic 
of  the  tooth. 

Stress  Index:  Upward,  out  and  backward,  back  and  inward, 
fore  and  outward  or  Intraalveolar,  Bucco-Distally,  disfo-pal- 
atally  and  mesio-buccaUy,  or  in  a  latero-rotary  direction. 


110 


(.'AST    COl.D    AMI     ronci'.LAI  X     IXI,A^■S 


□0B 


riii.  ]::n. 


Fia.  V21. 


Fig-.  122 


Fiff.  123. 


Fio-.  12-1. 


Q^ 


Fi-    I- 


V\ii.    l-.i 


Fiff.  127. 


CAViTN    i'i;i;i'ai;ai"I(»x  111 


l-;i(;iiT  \'iK\\s  OK  A  MKsio-I)isT()-()(.'('i.rsAi,  Cavity  in  ax  Ui'- 

PKR    SKCd.M)     P.lcrSIMIl.    AND    THE    ('AST    GOLI)     IXLAY     AIAUE    FOK    IT. 

Figs.  ]-20,  lli],  and  12l'.— A'icws  of  cavity.  Note  in  Fig.  120 
the  ronioval  of  tlio  wcakoiiod  lingual  cusp,  the  bovoliiig  of  the 
)iiargin.s  ocelusall}',  liuguallv,  gingivally,  and  bueeally.  Note  care- 
fully in  Fig.  121  the  formation  upon  the  occlusal  surface  of  the 
occluso-disto-lingual  plane  and  the  occluso-niesio-buccal  plane,  and 
in  Fig.  122,  a  view  illustrating  the  taper  of  the  entire  cavity  to 
insure  the  perfect  seating  of  the  inlay. 

Fig.  123. — Occlusal  view  of  the  carved  jnhiy. 

Fig.  124. — Cavo-surfacc  view  of  the  inlay.  Note  carefully 
the  definition  of  each  line  and  angle,  and  th(>  correct  reproduction 
of  the  occluso-disto  lingual  plane  and  the  occluso-mesio-buccal 
plane. 

Figs.  125,  126,  and  127. — Views  of  the  finished  operation. 
Fig.  125  shows  how  the  mesial  portion  of  the  g'old  inlay  may,  for 
cosmetic  reasons,  be  replaced  in  the  porcelain. 

Stress  Index:  Ujnvard,  out  and  backward  and  in  and  for- 
ward or  iNTKAALVKOr.AK,   hiliio-d i.^foJI  1/  and  Inunio-nx suiJIij. 


112 


CAST    (JOIJ)    AXD    rOr.CELAIX    IXLAYS 


□  Q 


Fig.  12S. 


Fie-.  129. 


Fig.  130. 


Fig.  i:jl. 


Fio-.  1.32. 


Fig.  y. 


Fi<r.  ]:;4. 


Fi'^.  ]:',:> 


('A\•|'^^■   im;kpai;a'I'I().v 


Eight  Views  of  a  Complex  Cavity  in  an  Upper  Second 
Bicuspid,  and  the  Eestoration  Made  tor  It  in  the  Shape  of 
A  Cast  Gold  Inlay.  The  Labial  Portion  of  this  Inlay  has 
Bken,  in  TfRN,  Inlayed  with  Synthetic  Porcelain. 

Figs.  128,  129,  and  130.— Views  of  the  cavity  and  bevels  of 
the  various  walls,  margins,  etc. 

Fig.  131. — Occlusal  view  of  tlie  inlay. 

Fig.   132. — Cavo-surface  view  of  inlay. 

Figs.  133,  134,  135- — AMews  of  finished  restoration  showing 
lin;>   of   demarcation    between    gold   and   porcelain. 

Stress  Index:      Upward,  out  and  backward,  in  and  forward   or 
Ixtkaalveolar,  ](i})i()-dist<tlhi  and  li»gito-mf.siaUy. 


114 


CAST    COLD    AXll    r()i;('i:i,Al  x     ixlavs 


'I'lic  door  of  all  (listo-oc'clusal  or  iiicsio-occliisal  ('a^■ities 
slioiiUl  ])n'S('iil  the  a])])('aiaiit'(_'  of  an  iiicliiKMl  ])laii('  iiistoad  of 
a  level  liori/onlal  sui'l'ace,  as  liiis  simple  prcM-autioii  will  relieve 
the  vertical  walls  of  any  possil)le  stress,  and  will  ])rove  a  ftreat 
factor  in  tlie  retention  of  an  inlay  ])laeed  njion  the  disto-oeolusal 
sui-faee  of  a  tooth  wliicli  luis  no  nei,i;lil)orini;'  teetli  in  o])position 
to  it. 

The  lloor  of  all  lahio-oeelusal  and  lin^iio-ocelnsal  cavities 


Fi{(.  !.■)(). — Stress  iiidcx  i'm  \\\i\icv  tcctli.  Xntc  In  tin-  ciMitiT  (if  tlic  (|ua(l- 
raiif^lcs  rfprcsciitiiifj  the  iiidImis,  the  liciivy  black  ni:r.ks  (IciKitin^;'  intense  iiitra- 
alvoftlar  stress,  which  is  lesseiieil  as  the  anterior  part  of  the  mouth  is  approa<ihed. 
I^eft  upper  soeoiid  molar  maike.l  with  Ictti'r  /'  inilieatiii";  tliis  toot)',  as  the  most 
nearly   |>er1'('('t   oih'   in    tliis   u]i|i('i    jaw. 

>lionld  pi'oenl  llie  app<'ai-ance  ol'  an  incline(l  plane  instead  of 
a  level  liori/oiilal  sni'face.  This  is  |)ait icnlai'lx'  essential  and 
even  imperalix'e  when'  tin-  niiiniii/t  of  (hi/hi/c,  support iini  llic 
ciiiinirl  is  sijifill,  and  where  1lie  ca\'ily  is  ol'  a  /Irplli  f/i-calcr  IIkiii 
llic  I hirl.i/rss  ol    llicsc   rcfhcdl   ildlls. 

As  a  ;;nide,  w  Inch  will,  of  c()nrse,  lia\<'  1o  he  \aried  as  Ihe 
cases    pi'esenl    1  heni.-el  \'es,    Ihe    I'ollowin,!;'    lahh'   of   the   dirfei'ent 


('A\■|'|•^    iM;i;i'Ai;.\'ri()N  1  1.) 

directions  in  w  liicii  slicss  is  hroiii^lit  to  hcai'  iij)oii  the  dilTcrciit 
tcct  li  is  here  ,^i\('ii : 

The  niiti  rior  tcctli  in  llic  nppcr  j;i\\  ni'c  (•;ill»'(l  npon  to  re- 
sist stress  exei-cised  ;i,i;;unst  tlieni  in  an  int i'aal\'e()hn',  labial, 
and  distal  direction;  that  is,  tliey  are  c()!istaiit ly  I'oi-ced  upwai'd, 
ontward,  and  hackw  aid. 

The    uppei-   ciis|)ids.   in    a    slight  !>■    int  raalxcohii',    inarkcflly 


Fifj.  1.T7. — Stress  index  for  lower  teetli.  Xote  in  tlie  center  of  the  qiiad- 
ranf^les  representing-  the  molar,  the  heavy  Mack  marks,  denoting  intense  intraalveolar 
stress,  which  is  lessened  as  the  anterior  teeth  are  approached.  Right  lower  second 
molar  marked  with  thn  letter  P,  indicating'  this  tooth  as  the  most  nearly  perfect  on 

this  lower  iaw. 


hd)ial,  and  e<piall_\-  mesial  and  distal  direction,  so  that  tlie  lat- 
ter stress  is  ])raetically  halaiiced. 

Bieiisi:)ids,  in  a  markedly  iiiti-aalveolai-  lahio-distal  and  lin- 
,j;'iu)-inesial  or  upward,  outwai'd,  hackward,  inward  and  forward 
direction,  the  lattor  two  directions  ]ir(Ml(^minatin,u'. 

^[olars,  ill  a  markedly  intraahcolai',  mai'kedly  l)iicco-distal, 
])alato-distal,  mesio-huccal  or,  Ix'tter,  in  a  rotai'V  direction,  hnc- 
co-distal  dii'ection  pi'edominat  in.i;'. 


IIG  CAST    GOLD    AXli    I'OIUKLAIX     IXLAVS 

The  lower  teeth  are  caUetl  upon  to  resist  stress  exercised 
upon  tlieiii  in  tlie  follo\vin<;'  direetions: 

The  four  incisors,  intra  lingual  and  mesial;  that  is,  tlie  four 
lower  incisors  are  constantly  being  forced  downward,  and  in  a 
linguo-mesial  direction.  The  downward  pressure  is  counter- 
acted by  the  suspension  ligament,  and  the  lingual  impulse  is 
checked  by  the  ligament  and  the  tongue. 

The  cuspids  are  resisting  a  pressure  tending  to  force  them 
in  an  intra,  mesial,  distal,  and  a  minor  lingual  direction;  or 
downward,  forward,  backward,  and  inward. 

The  bicuspids  are  being  driven  mai-kedly  intra  and  lingually 
and  in  a  minor  way,  intradistally  and  intramesially. 

The  molars  bear  a  stress,  decidedly  iutraalveolar  markedly 
intralnicco-distally,  and  intralinguo-mesially,  minor  intradisto- 
lingually  and  intramesio-buccally. 

All  of  these  indications  of  the  direction  of  stress  are  for 
teeth  in  normal,  or  very  nearly  nonnal,  occlusion;  with  au}^ 
marked  deviation  from  the  normal  occlusion,  will,  of  course, 
have  to  come  a  study  of  the  individual  case  and  a  preparation  of 
the  cavity  to  fill  the  need  of  the  case  at  hand. 

If  the  foregoing  stress  index  is  carefully  noticed  and  mem- 
orized, deductions  may  be  made  that  will  show  the  direction  of 
stress  which  any  case  presenting  itself  may  be  subjected  to. 
The  best  manner  in  which  this  should  be  done  is  to  take  im- 
pressions in  plaster  of  the  case,  and  obtain  what  are  called 
study  models.  All  the  teeth  needing  attention  having  been  pre- 
viously marked  off  on  a  chart,  the  models  and  the  chart  are 
now  carefully  scrutinized  and  the  teeth  needing  attention  arb 
marked  off  on  the  models. 

A  close  stud\-  of  the  n])|)('r  and  lowci'  models  individually, 
and  in  their  relation  1o  one  anothei',  is  now  begun,  and  the  cavi- 
ties may  be  outlined  to  their  surface  extent,  if  the  student  so 
desires;  as  a  fui-ther  aid,  the  cavities  may  even  be  chiseled  into 
the  ])laste)'  teeth,  as  the  oix'i'ator  would  liax'e  tliein  ap])eai'  in  the 
mouth.  This  would,  of  eoui'se,  i-endei-  the  models  useless  as 
record  jiiodels,  and  would  necessitate  the  taking  of  two  other 
impressions,  or  the  models  at  lian<l  may  be  reproduced  before 
any  cavitx'  cutting  is  d(;iie. 

This    may    be    aeconiplislie<l    by    jilacing    the    model,    wdiich 


Fig-.   138. 


Fif4S.  i:!S  and  ];J9. — Buccal  and  liiioual  views  of  a  case  of  nearly  normal  oc- 
clusion. Xoto  the  peifect  interdigitation  of  the  cusjjs  of  the  upper  and  lower  teeth, 
the  constriction  of  the  teeth  at  the  gingival  circumference,  the  slight  malposition 
of  the  molars  as  manifest  in  the  lack  of  relation  of  upper  third  molar  to  lower  sec- 
ond molar.     (Dr.  J.  Lowe  Young.) 


.lis  CAST    COl.li    AXn     I'DIU'KI.Al  N     I  N  I  .A  ^  S 

lias  lu'cii  iiiadr  pcrrectly  siiiootli  with  talciiiii,  uj)()ii  a  .u'lass  slab, 
and  surroundiiii;-  it  with  a  tin  or  hiass  or  t;lass  vh\<^,  about  four 
iuclu's  s([uai-('  and  about  two  and  one-half  or  tliroc  inclics  lii<;'li. 
Mt'ltiHl  <;-t'latin  is  ih)w  poured  ui)on  the  model,  covering'  the 
latter  coiiii)letely.  it  will  be  best  to  till  tlie  riii<>-.  AVlieii  tlie 
iielatin  lias  set.  the  riii.i;-  Is  inverted,  and  so,  of  course,  is  the 
model.  With  a  sharp  knife  some  of  tlie  ,i;-elatin  is  trimmed  away, 
and  lieeause  of  the  elasticity  of  tlie  ii'elatin,  the  mochd  may  he 
removed. 

Thus  a  -Aelatin  im])ressiou  of  the  model  i.s  secured,  and  into 
this  impression,  plaster  of  Paris  may  be  poured  and  a  record 
model  obtained. 

In  the  stud\'  of  these  models  for  determination  of  stress, 
the  operator  should  be  in  possession  of  a  comi)lete  history  of 
the  patient.  A  careful  examination  of  the  nniscular  structures 
of  the  face  should  be  made  and  tli(»  extent  of  the  freedom  in 
a  laterorotai->'  dii-ection  enjoyed  by  the  mandible,  should  he 
noted. 

It  must  be  borne  in  mind  that  the  shock  to  a  tooth  under 
stress  mastication  is  inversely  pi'oportional  to  the  elasticity  of 
the  susi)ension  li,i;ament,  oi-  the  ])eri(lental  membrane,  and  the 
free  moljility  of  the  mandihle. 

The  elasticit.N-  of  the  suspension  ligament  is  inversely  x^ro- 
])ortiona1  to  the  IVee  mobility  of  the  mandible.  This  is  a  sec- 
ondai-y  (-(Uidition  ol'ten  I'esnitin.i;-  from  a  ])oor  condition  of  the 
teeth,  finally  aifecting  them  to  such  an  extent  that  the  effort 
to  masticate  is  ])ainful,  ajid  so  the  ])ati(-iit  i-efrains  from  exer- 
cisiiif;-  the  necessai-y  ])i-essure  and  shil'ls  the  mandible  beloi-e 
the  maxinmm  of  pressure  oi-  tension  i'e(piii-e(l  for  maslicatifui 
has  been  exerted.  This  will,  in  tim<',  jii-oduce  the  coiulition  of  a 
too  fi'cely  mo\ablc  mandible;  an<l,  because  of  lack  of  i)roper 
exercise  oT  the  peridental  tissues,  pat liolo,i;ic  clian,i;-e  will  take 
place  in  tin  111,  the  elTect  of  which  change,  unless  i-emedied,  will 
be  cumulative,  and  lead  to  the  iiltimale  loss  of  the  teeth. 

rpoii  resloratioii  of  occlii.-al  balance,  llie  condition  o!'  the 
loo  I'l-eely  moving  mandible  ma\  be  iiiodilie<l,  il'  Ihe  alttiition 
of  the  j)atient  In-  properix-  diivcted  lo  II le  inipoitaiice  oj'  balance; 
between  the  \'ai-ious  raeloi.-  in  occlusion. 


(  A\ri'\      nM'.l'AKA'I'lOX  1  1 


SUMMARY  rOR   CHAPTER   V 

Cavity  Preparation 

I.    .\;niii'  Mirfaci's,    line  ;nij;l('s  Mini   jmiiit   .•iii,l;1i's   of 
(a)    Incisors 
(1))    Cuspids 
((•)    ]'>iciisj)i(ls 

(d)  Mdlars. 

L'.  \\'li:it    is   iiicuiit   by  the  iiiiiiiuiii'  jirca  oT  a   tn.itii  .' 

;i.  Wliy  arc  ccitain  airns  siisc('|itiiili'  tn  ijci-ay  .' 

I.  Xanic   till'    iiiiiiiiiiii'   ai'a^. 

•").  Xaiiic  till'  siisi-c|itili!i'  areas. 

().  Wliat    raclms    (liter    into    cavity    pri'icirat  ion  .' 

7.  Wli.-it    are    tlic    rc(|iiiiiMncnts    fi^r    tin'    foi  niatimi    of    a    cavity    to    receive    a 
cast  ;;-oliI  inlay  .' 

S.  What    instiuinents   aic    necessary   for   ]iro|ier   cavity    [ireparutinn  ? 

!t.  Name   the   j;;'iieral    rules   for   ti'cth    cutting. 

10.  What   steps  are   taken    hefure   the   cavity    |irep;iratiim    is   cinnnieiiced  ? 

11.  Name  the  types  of  cavities  and  their  suhdivisions. 

12.  Explain  what  is  meant  by  tlu'  surgical  mork  iu  the  preparation  of 
cavities.'     Tlie  formative  work?     The  alterative  work? 

1."!.  Why   is  the  anatomic   restoration  of  the   occlusal  surface  necessary? 

14.   How  are  the  mari;iiis  of  the  cavity  to  l)e   prejiared? 

1.1.  What  general  rule  can  be  ai)|died  to  the  foi'matixe  pre^iaration  of  the 
cavity? 

l(i.  Kxplain  the  teclniic  of  the  preparation  of  tli"  ca\ity  flinir  in  teeth  with 
deep   cusps. 

17.  Illustrate  in  cidss  srctimi  the  prepaiation  iu  molar  or  bicuspid  of  tiie 
follo\vini>-  cavities:  (a)  Disto-ocidiisal,  (li)  Mesio-dcclusal,  (c)  Linguo-occlusal, 
(d)   Bucco-occlusal. 

18.  Illustrate  in  cross  sectimi  tlie  pieiiai  ation  in  a  m<dar  or  liicusjiid  of  a 
mcsio-occluso-di.sto-Iinguo- buccal    i'a\  ity. 

19.  What   is   a   mesial    jdane.'      What    is   a   distal    ].]ane? 

•20.   What   is  the   oc(duso-distodingual   plane.'     What   is  the  mesio-buccal  ]dane? 

21.  (ii\'e  the  directiinis  of  stress  which  tlie  teeth  aie  called  upon  to  withstand. 

(a)  I'pper    incisor 

(b)  I'])])er    cuspids 

(c)  I'jiper  bicuspids 
(d  )  I'p])er  nujlais 

(e)  Lower   incisors 

(f)  Lower    cusjiids 

(g)  Lower    ])icus])ids 
(h)  Ijower    nndars. 

22.  What  is  the  iiurpose  of  making-  study  models? 

2."!.  Give  the  gauges  and  sizes  of  supplemental  pins  when  used.  How  would 
yciii   prepare  these  jiins  fiU'  use.'     Why  slieuld   the  use   of  the.se  pins  be  avoiih^l? 


CHAPTER  VI 

THE  MESIO-HISTO-OCCLUSAL  CAST  CiOLD  IXLAY 

THE  CAST  GOLD  COMPLEMENT  FOR  A  TOOTH  PRE- 
SENTING A  MESIO-DISTO-OCCLUSAL  CAVITY 

AVe  iiiiist  recognize  tlie  inherent  qualities  of  whatever  suit- 
able materials  we  wish  to  use  in  our  work;  never  seek  to  de- 
stroy these  qualities,  but  rather  urge  their  exj^ression  in  a  man- 
ner best  calculated  to  enhance  our  effort. 

This  is  an  abstract  principle,  the  recognition  of  which  will 
save  artists  and  artisans,  as  well  as  those  engaged  in  many  other 
useful  iDursuits,  many  discouraging  failures.  It  is  one  of  the 
keystones  in  the  house  of  truth;  one  may  go  further  and  say 
that  it  is  the  very  cornerstone  of  success  in  one's  manual  or 
mental  work. 

The  properties  of  all  things  which  enter  into  inlay  Avork 
must  be  considered  in  two  ways  or  from  two  angles.  First, 
in  their  oneness,  or  aloneness,  a  state  of  imperious  reserve  and 
hauglity  aloofness — the  al)solute  state;  and  second,  in  their 
interdependent  copartnership  with  their  coagents  a  state  of  ad- 
justment now  tardy,  now  ready,  now  yielding,  or  impelling  yield, 
finally  in  harmonious  understanding  of  the  properties  of  each 
other,  yielding  tlieii'  own  to  acfjuire  new  ones — the  relative  slat(\ 

In  inlays  made  for  siiii])le  cavities,  oi-  iiiesio-  oi-  disto-oc- 
clusal  cavities,  it  becomes  necessary  to  ])it  tlie  inherent  pressure 
of  the  gas  or  air  used  in  casting  against  the  inlier(uit  inverse 
pressure  of  tlie  molten  gold.  By  the  in]i('r(  til  iii\-erse  pressure 
of  the  molten  gold,  is  meant  ils  loss  of  cube  dimension  when 
changing  from  a  inolteii  to  a  solid  state. 

In  considei-ing  gold  and  platinum,  tiie  loiinei-  the  (pian- 
titatively  ])i-edominating  iii<'tal  used  in  iiday  woik,  we  liiid  that 
they  ai'e  vei-y  duelije,  i-oyal  metals  sulijecl  to  var_\ing  dimen- 
sional changes,  uinhM'  vai'xing  intense  tenipei'at  ures,  the  maxi- 
rmim  gain  in  cube  dimension  heing  i(a('he(l  at  the  hoiling  point. 


.MKS|()-|)IS'l'()-()CCrATSAL    CAST    COM)    IXLAV  121 

Upon  i-ciii()\;il  of  tlic  licatiti,!;-  clciiiciil,  lh<'  iiiollcii  mass  will 
,i;-i-a»luall\'  cdoI  hy  ,i;i\iiii;'  up  its  iulciisc  heat  to  llic  air  aii:l  tliiii<>,'S 
surroiiiidiii^-  it,  aii<l  (luriii<2,'  tlio  cooling-  process  or  process  of 
crystallization,  will  lose  in  cu))e  dimensions  tlie  amount  gained 
while  its  tem])('iature  was  l)eing  raised  From  I'oom  temperature 
to  ixjiliiig  ])oiiil:  or  simi)ly  this,  gold  and  ])latiiium  will  ex])and 
on  being  lieatcd  witii  maximum  ex])ansi()n  at  their  boiling  p)oints 
and  will  contract  on  cooling  with  maxinnim  contraction  on  r(nicli- 
ing  room  tempei'ature  again.  Tliis  very  plienomenon  may  ruin 
work  or  may  contribute  markedly  to  the  success  of  it  wlien  con- 
structing an  inlay  for  a  mesio-disto-occlusal  cavity.  It  depends 
greatly,  if  not  altogether,  on  how  the  cavity  in  the  tooth  to  be 
inlayed  is  prepared. 

The  form  of  cavity  preparation  advocated  in  this  volume 
for  mesio-  or  disto-occlusal  or  for  lahio-  or  linguo-occhisal  cav- 
ities will  not  do  for  mesio-disto-occlusal  or  for  labio-linguo-oc- 
clusal  cavities. 

In  all  cavities,  hut  the  last  groups,  an  inlay  is  exactly  what 
its  name  implies;  in  the  latter  two  groups  it  takes  a  new  form 
unto  itself  Avlien  two  things,  an  inlay  and  an  onlay  are  merged 
into  one.  vSo  that  a  cast  gold  inlay  complement  for  a  mesio- 
disto-occlusal  or  a  labio-linguo-occlusal  cavity  may  be  truthfully 
called  an  on-inlay,  the  occlusal  and  the  extreme  inner  or  cavo- 
part  of  the  mesial  and  distal  portion  of  it  Ijeing  the  inlay,  and 
the  extreme  outer  part  of  the  mesial  and  distal  portion  of  it, 
that  is,  the  extreme  buccal  and  lingual  sections  of  the  mesial 
and  distal  portions  of  the  gold  complement  ])eing  the  onlay. 

CAVITY  PREPARATION 

1.  Oj)en  tile  occlusal  surface  by  means  of  a  earlxn'uiidum 
wheel  %o-  Yn-  of  an  inch  wide  held  in  the  conti-aangie  liandpiece, 
the  stone  is  to  l)e  run  under  water. 

2.  Eemove  the  mesial  and  distal  ])ortions  of  the  tooth  by 
the  use  of  a  safe-sided  carl)orundum  disc  held  in  the  straight 
or  contraangle  handpiece  as  the  need  j^resents,  these  discs  to  be 
run  under  water.  These  portions  are  removed  in  such  a  man- 
ner that  the  mesial  and  distal  surfaces  of  the  tootli  will  tai)er 
slightly  toward  the  occlusal. 


IL'J 


CAST    COLD    .\XI»     1'()|;C1:LAI  X     INLAWS 


Fig.  14U. — The  fii>t  cut  after  the  dei-ay  ha^  Ix'iJi  rejiiuv^  d  in  tlie  preparation 
of  a  mesio-occlu!<o-distal  cavity  in  a  molar.  This  is  the  occlusal  cut  and,  barring 
extensive  fissure  involvement,  should  give  at  once  the  entire  width  of  tlie  main  cav- 
ity upon  the   occlusal   surface. 


Fig.  in. — 'I'lie  .'second  cut,  lctiio\al  of  tiic  iiioiiil  wail,  to  |,i()\idr  for  lln' 
unlay  part  of  the  inlay.  A.joining  this  flat  wall  are  m<'ii  IIu-  lingual  oi  jialatal  and 
lal.ial  or  buccal  guides,  as  well  as  the  gingival  seat  of  tlie  cavitv.  .Vote  that  the 
mesial  wall  has  been  cut  .-o  that   it  trtpors  ^lightly  toward  the  ocdusul  wmII. 


.MKSIO-DlS'l'O-OCCH'SAF.    CAST    COI.D     IXI.A^' 


Fig.  14l'. — The  tliiid  cut.  The  removal  cf  tlic  ilistal  \vall  to  proviile  for  tlic 
onlay  part  of  the  inlay.  Ailjoiiiino-  this  flat  wall  arc  sc'ii  tlic  linmial  or  ])a]atal 
and  laliial  or  buccal  guides,  as  will  as  the  gingival  scat  of  the  cavity.  Note  that  the 
distal  wall  lias  been  cut  so  that  it  ta[iers  slightly  toward  the  oc(dusal  wall. 


Fig.  l-i;j.--Thc  hiial  cut.  The  licvcj  ii|ioii  the  occlusal  surface  continuous  with 
the  mesio-lniccal,  distolniii'al,  nicsic  lingual,  and  distodingual  guides  of  the  cavity, 
which  guides  are  \>:  \-cleil  outwaiil.  An  inlay  made  for  a  cavity  siudi  as  this  nuisr 
ncvci-  be  put  into  position  before  thoriuighly  lubricathig  it  with  a  small  amount  of 
carliolatc(l    \  asciinc. 


llM 


CAST    COLD    AND    POllCELAlX    IX LAVS 


Fig.  144. — The  wax  inlay  made  iior  the  niesio-occluPo-distal  cavity.  It  is 
mounted  ui^oii  a  sj^rue  wire  and  held  in  the  cnieible  former.  Note  reproduction  of 
all  linos  and  bevels  in  the  wax. 


Fig.  14.';.— The  finished  inlay  in  position  ujnm  the  toofli.  The  sniiiM  iniHiunt  of 
contraction  of  the  {^old  served  heri'  to  more  (dusdy  I'urcc  I  he  iim's:;iI  ;iimI  (list;il 
onlays  against  the  tooth  sui-fa'-cs.      This  is  a  liyhiid.  not    ;in   iiihiy,  Iml    ;iii  on  inhiy. 


.M  KSIO-niSTO-OCCU'SAr.    CAST    OOIJ)     IXLA\'  ^ '27) 

15.  I*i-()\i(l('  buccal  or  lahial  and  lingual  .guides,  and  ])i'()- 
\u\v  the  ,i;'iii,i;ival  seal  in  llic  cavity  by  means  of  vci-y  lliin  cyliii- 
di'ical  carborundum  stones  held  in  the  coidi'aani^le  handj)ieee 
and  run  uikU'i-  water. 

4.  Polish  all  cavity  walls  by  means  of,  first,  coarse  sand- 
paper, followed  by  liner  sandiDajier,  and  ultimately  by  fine 
cuttletisli  discs. 

The  removal  of  all  decay  and  all  doubtful  tooth  tissue  is 
imperative  and  should  be  done  before  any  attempt  is  made  to 
prei)are  the  cavity  at  all.  The  practice  of  leaving  this  until 
the  last  for  fear  of  creating  undercuts  is  reiDrehensibly  l)ad 
])i'actice. 

The  gi-iniling  or  cutting  of  tooth  structure,  except  it  be  done 
with  chisels  before  all  the  decay  has  l)een  removed,  is  likely 
to  contaminate  the  as  yet  unaffected  layer  of  dentine,  a  result 
as  undesirable  as  it  is  ultimately  disastrous. 

If  the  saliva  interferes  with  clean  rapid  work,  the  rul)l)er 
dam  must  be  ai)i)lied. 

All  that  has  previously  been  said  in  the  chapter  on  Cavity 
Prei^aration  for  simple,  compound,  and  complex  cavities  ap- 
plies in  M.O.D.  cavities;  that  is,  the  adjoining  teeth  must  be 
scaled  and  i)()lished,  and  by  far  the  best  way  is  to  subject  the 
patient's  mouth  to  a  thorough  jorophylactic  treatment.  The 
dam  may  then  be  applied  and  the  cavity  joreparation  undertaken 
and  completed  as  directed. 

The  tooth  should  then  be  washed  with  warm  water,  until 
no  sign  of  debris  exists;  tooth  and  cavity  are  now  flooded  with 
alcohol  (95%)  and  dried  with  a  gentle  w^arm  air  l)last.  A  gen- 
erous quantitiy  of  chloroform  is  now^  ajiplied  and  again  the 
warm  air  is  used  to  dehydrate  tlie  tooth  presenting  the  cavity. 
The  next  api)lication  consists  of  a  saturated  solution  of  potas- 
sium carbonate  in  glycerine  Hooding  every  jiart  of  the  cavity — 
this  solution  is  allowed  to  remain  in  the  cavity  for  about  five 
minutes,  when  the  warm  air  is  again  apjilied. 

The  glycerine  will  further  dehydrate  the  dentinal  tubules, 
and  the  carbonate  of  potash,  held  in  solution,  will  enter  to 
efficiently  occlude  these  with  a  material  acceptable  to  the  tooth 
economy. 

In   order  to  exclude   the   ])ossil)ility    of   thermal    shock,    this 


ll'()  CAST    CdlJ'    AXIi    I'OltCKLAlX     l^■|,A^■s 

])roce(liirc'  may  l)c'  rollowiMl  up  \\\{\\  a  soliilioii  of  i-osiii  in  clilo- 
rofonn,  'o  drain  of  rosin  to  -!  di-ains  of  cldorofoi'in.  This  makes 
a  very  toii.uli  \aniisli,  wliicli  will  cliii.i;-  to  the  (Iculiiie  walls  in 
tlie  cavity,  and  wliicli  will  (Milcr  tlic  (Icntinal  tubules  to  some 
extent.  It  is  a  nonconductor  of  tlicinia.l  changes  and  Avill  pre- 
vent sluK'k  to  the  tooth  wlien  tlic  inlay  is  set  and  after  it  has 
l)een  set.  Tliis  varnish  may  ])e  applied  witli  a  ])ellet  of  cotton 
and  it  nnist  1)e  dried  witli  the  warm  air. 

When  all  these  preparations  liave  ])e(  n  ('om])leted,  we  may 
])r()ceed  to  l)and  the  tooth  or  put  a  matrix  on  it  and  to  force 
the  wax  into  the  (^n'ity — that  is,  Ave  may  ])i-oceed  to  make  tlie 
wax  inhiy. 

T]\h  slioidd  l)e  (hjne  hy  the  direct  metliod  as  already  de- 
scribed, or  hy  the  use  of  the  indirect  as  an  accessory  to  the  di- 
rect as  also  descril)ed. 

TJie  mode  of  cavity  ])reparation  advocated  and  illustrated 
lie]-e  for  mesio-occluso-distal  and  B.O.L.  inlays  takes  into  con- 
sideration and  ])artnerslii])  the  sniall  amount  of  contraction  that 
will  take  i^lace  in  the  castin^;'  of  the  metal  and  make  use  of  this 
property  of  the  metal,  in  that  thus  a  hetter  coaptation  is  ob- 
tained between  iiday  and  tooth. 

This  preparation  Avill  not  do  for  mesio-occlusal,  disto- 
occlusal,  bucco-  or  liii<;uo-occkisal  cavities,  because,  in  (i,ettinf!,- 
a  closer  adaptation  mesially  or  distally,  buccally  or  linoually, 
the  g'old  would  be  ])ulled  away  from  the  margins  upon  the 
occlusal  surface,  and  tlie  marg'ins  u])on  this  surface  would  be 
<x])os(m1  to  the  recurrence  of  decay. 

SUMMARY   FOR   CHAPTER   VI. 
The  Mesio-Disto-Occliisal  Cast  Gold  Inlay 

1.  iJocrilx.'  till-  ])i('i»aiati<)ii  of  an  ]\I.O.D.  cavity. 

2.  Dc^f-iilio  the  jji-cparatioii   of  tlio  cavity   for   tli'   rci-cptidii    ol'   tlic   wa.\. 
:;.  Dcscrilio  tlip  taking  of  tlio  inqucssioii. 

4.  What  quality  of  tin'  cMi^in^  metal  is  ifconni/.f.;!  in  Uif  iMc|i;u;it  inn  of 
iiif'sio-di.sto-occlii.'ial   or  a   hiiccn  ()i-<-hiso-]iii!>u;il   ciixitN? 


CIIAPTFJ?   \'ll 
TlIK  SKLb:("ri()X  OF  TWi:  PL'OPKi;   WAX 

Wax  is  a  name  ^iveii  to  various  animal  excietioiis  or  vo<;<'- 
tal)k'  suhstanccs  liavin<;-  some  similar  and  some  identical  ]jliys- 
ical  2^t'<^*i^diaiilies,  l)iit  dilferiiio-  in  eliemical  composition,  and 
possessin<;-  a  definite  ])liysical  iM(l!\i(luality. 

All  waxes  are  liydrocarhon  coni])onnds,  icJattMl  to  the  ;4rouj)S 
of  oils  and  fats,  common  wax  differing'  from  oi'dinarv  wax  in 
2J0ssessing  no  glycerine. 

A  great  many  waxes  are  known  to  commerce  and  employeil 
in  tlie  arts. 

The  most  widely  known,  or  common  wax,  whicli  forms  tlie 
honeycoml)  of  tlie  wonderful  V)ees,  is  in  its  nntampered-witli 
condition,  a  comparatively  hard  substance,  nnctuous  to  the 
touch,  tasteless,  and  of  a  sweet  odoi-.  It  is  easily  obtained  from 
the  combs  by  immersing  them  in  hot  water,  when  the  wax  will 
tloat  to  the  sui-face  as  a  thin  oily  fluid.  This  fluid  is  drawn  oft" 
and  allowed  to  solidify  into  cakes.  This  wax  may  l)e  bleached 
or  purified  into  cera  alba  or  white  wax,  l)y  the  following 
2)rocess  : 

In  tlie  sliape  of  thin  flakes,  the  wax  is  ex])osed  to  the  air 
and  light  until  the  surfaces  of  the  flakes  have  been  bleached, 
much  aftei-  the  process  used  in  bleaching  linen.  The  wax  is  then 
i-emelted,  and  tlius  new  surfaces  are  brought  under  the  bleaching 
influence  of  light  and  air.  This  is  continued  until  a  uniform 
white  wax  is  obtained. 

Bleaching  ])owders  as  chemical  ageids,  are  sometimes  used, 
but  they  are  objectionable  because  the  whole  of  the  chloride  is 
not  removed  in  the  process,  and  in  the  subsequent  ])urning  of 
the  wax,  irritating  and  harmful  fumes  of  hydrocldoric  acid  are 
given  oft'. 

AVhite  wax  made  ],\u-('  by  the  ])rocess  of  boiling  and  bleach- 
ing consists  of: 

127 


128  CAST    COLD    AND    POIU'EI.AIX    INLAYS 

Creatine,  80  per  cent,  soluble  Jii  l)oiliii^'  alcohol  and  an  in- 
soluble ^vaxY  substance  called  niyi'icin,  nearly  20  i)er  cent.  A 
small  ijroportion  of  cerolin  gives  hardness  to  the  nuiss. 

The  wax  is  tasteless,  inodorous  and  seniitransparent.  At 
85°  F.  it  becomes  somewhat  jjlastic,  and  may  be  molded  with 
the  fingers.  It  melts  at  1-15"  F.  It  is  chiefly  used  for  making 
candles,  artificial  flowers,  and  wax  fruits.  It  has  emollient 
proi^erties  and  is  employed  in  the  making  of  ointments.  Because 
of  its  high  jDrice,  it  is  often  adulterated  with  sj^ermaceti  (an 
inferior  wax  chalk),  starch  and  finely  jjowdered  silex,  etc. 

Another  wax  is  made  from  candleberry,  known  as  wax 
myrtle,  wax  or  tallow  tree,  or  bayberry  (Myrica  Cerifera),  a 
small  tree,  or  more  generally  a  low  spreading  shrub,  a  native 
of  the  United  States,  most  abundant  and  luxuriant  in  the  South. 
The  evergreen  leaves  are  dotted  with  resin  glands,  and  are 
fragrant  Avhen  bruised.  The  drupes,  popularly  called  berries, 
are  about  the  size  of  peppercorns,  and,  Avlien  ripe,  are  covered 
Avitli  a  greenish  white  wax.  The  wax  is  collected  by  boiling  and 
skinnning  them,  and  is  afterwards  melted  and  refined.  A  bushel 
of  berries  will  yield  four  or  five  pounds.  An  excellent  scented 
soap  is  made  from  it. 

Paraffine  Avas  practically  uidvnown  to  the  candle  maker  un- 
til 1847-50,  when  the  late  Dr.  James  Young  discovered  the 
method  of  producing  hydrocarbons  by  the  distillation  of  coal 
at  a  low  red  heat.  It  is  now  produced  in  Scotland  from  shale 
in  large  quantities;  in  the  United  States,  from  petroleum;  in 
Germany  (in  smaller  quantities),  from  brown  coal;  and  in 
Burma,  in  yet  smaller  quantities,  from  rangoon  petroleum. 
Crude  i)araffine  (technically  "scale")  contains,  in  addition  to 
the  hai'der  ])ai-affine  suitalilc  foi'  candh-s,  soft  ])araffine  (used 
by  match  makers),  and  a  small  j)ro])oitioii  of  oil.  The  scale  is 
melted  and  cast  into  thin  cakes,  which  are  then  placed  on  slop- 
ing shelves  in  an  oven  kept  at  a  regular  temperature  sufficiently 
liigh  to  melt  tlie  soft  paraffine.  The  soft  ])araffine  and  oil  flow 
away,  and  leave  Ixhiud  a  mass  of  hard  ])ai-arfiii('  it'ady  I'oi'  the 
caudle  maker. 

Miii('|-al  wax  is  a  name  <'Ui|»l«)\('d  foi-  cci-taiu  fossil  lixdi'o- 
carboiis,  occuri'iiix  (iiicllx'  in  sinall  (|nan1i1i('s  in  carboniferous 
formaliou.     Tin-  connnoncst   owe  of  llicsc  is  ():nj,-ciil c,  used   in 


SKI.HCTIOX    OK    TIIK    I'lIol'Ki:     WAX  129 

the  caiidlc  iiidust  I'V.  A  j)i('])ai';it  ion  of  this  siiWstaiicc  known  as 
ozokcrii/c,  is  cinploNcd  in  \\i"  niakiiiL!,'  of  ointniciits.  It  has  tlic 
advaiita^'e  o\('i-  lard  I'oi"  this  ))Ui-])os('  as  it  do(  s  not  sjjoil  with 
time  and  aftv,  and  (hx's  not  turn  i-ancid. 

Tht'i'e  is  a  f^roat  vai-ictx"  ol'  tlicso  vc^ctahh'  and  mineral 
wa\(^s,  hid  these  <  iiunierate(l  will  suffice  to  enable  the  reader 
to  learn  something'  ol'  tlie  ori<4in  and  ])ioi)ei-ties  of  the  most 
w  i(k'ly  known  to  the  arts  and  eonnnerce. 

]t  must  he  said  that  in  and  hy  themselves  none  of  these 
waxes  arc  suitahle  foi'  inlay  purposes,  Ix'cause  for  this  pur})Ose, 
the  wax  must  ])ossess  the  following  i)roperties : 

1.  It  must  leave  absolutely  no  residue  witliin  the  mol<l  after 
it  has  been  subjected  to  the  proper  amount  of  heat. 

2.  It  nuist  vohitilize  at  a  tem])erature  nuicli  Ijelow  tliat  at 
which  the  disintegration  of  the  mold  hegins. 

'.].  It  nmst  remain  rigid  at  25°  F.  above  the  temperature  of 
llie  moutli,  which  means  that  it  will  break  before  it  will  bend. 

4.  It  nmst  possess  when  heatcMl,  tlie  property  of  j^erfect 
l)Iasticity. 

5.  It  nmst  not  tlake  when  In'ought  to  a  ijlastic  state. 

6.  It  nuTst  1)6  of  a  dark  shade,  preferal)ly  green,  so  as  to 
more  easily  detect  marginal  deficiencies. 

7.  It  must  he  capal)le  of  being  added  to  witli  hot  insti-u- 
ments. 

8.  It  must  l)e  suljject  to  the  least  i30ssi))le  variation  in  Inilk 
at  slightly  al)ove  or  slightly  helow  normal  temperature. 

9.  It  must  i)erniit  of  l)eing  carved  to  sharp  definition  of 
outline. 

10.  It  must  be  relia])le  in  these  qualities  so  that  the  worker 
may  l)e  ena])led  to  definitely  (lu])licate  his  operations. 

^'hese  lU'operties  are  possessed  hy  no  single  wax,  and  so  a 
combination  of  waxes  had  to  be  carefully  studied  out  and 
experimented  with  in  order  to  obtain  the  desired  results. 

A  simple  stellate  cavity  was  prejDared  in  a  molar  tooth  and 
wax  inlays  were  made  for  it  from  the  various  Avaxes  offered 
to  the  profession. 

These  wax  inlaw's  were  invested  in  the  refractory  com- 
pounds, one  inlay  at  a  time.  A  separate  mix  of  investment  was 
made  for  each  inlay.    As  nearh^  as  possihle,  jihysical  conditions, 


130  CAST    GOLD    AXD    POltCELAJX    JXIAYS 

siU'li  as  quantity  of  powder  and  water,  and  relative  proportions, 
as  Avell  as  temiDerature,  Avere  dn])li('ated  in  eacli  instance,  and 
the  automatic  mixer  was  used. 

It  nuist  ))e  ap])arent  tliat  if  tlie  i:)recautions  of  makino-  a 
separate  mix  of  investment  for  each  inlay  liad  been  omitted,  and 
if  an  attem])t  liad  l)een  made  to  invest  several  of  the  wax  pat- 
terns at  one  time,  the  physical  conditions  and  environments  of 
the  second  mokl  would  have  been  different  from  those  of  the 
first,  and  tlie  conditions  governing'  tlie  third,  fourth,  fifth  and 
sixth,  etc.,  would  all  have  varied  from  those  of  the  first,  and 
from  those  of  each  other,  and  any  deductions  made  from  such 
experiments  would  necessarily  have  carried  with  them  an  ele- 
ment of  guess  and  surmise,  which  from  my  point  of  view  would 
have  rendered  them  altogether  unreliable. 

It  is  always  well  to  remember  that  the  fluidity  or  creamy 
consistency  of  the  mixed  refractory  compound  changes  as  the 
moments  pass,  and  what  may  be  practically  a  fluid  at  tlie  time 
of  investment  of  the  flrst  wax  inlay,  would  prove  to  be  but  a 
plastic  comx)ound  at  the  investment  of  the  third  or  fourth  pat- 
tern, and  its  plasticity  would  be  a  rapidly  disappearing  and 
hence  much  interfering,  quality  of  very  doubtful  merit. 

Each  mix  was  given  an  even  half  hour  to  harden  and  each 
flask  was  subjected  to  the  flame  of  the  Bunsen  burner  under  a 
''Platcheck  stove." 

Upon  casting,  it  Avas  found  that,  at  a  temperature  that 
would  not  endanger  the  integrity  of  the  mold,  most  of  the  waxes 
left  a  residue  that  excluded  the  possibility  of  satisfactory  re- 
sults, and  that,  in  order  to  clear  the  molds  of  this  residue,  the 
temperatui-e  had  to  be  raised  to  a  degree  that  made  the  mold 
too  weak  to  i-esist  internal  ])ressure,  thus  obliterating  margins 
and  producing  a  casting  unflt  for  use. 

These  experiments,  cariied  on  for  a  lengthy  i)eriod  of  time, 
justify  my  conclusion  that  up  to  the  present,  the  Taggart  green 
wax  is  till'  most  ideal  wax  with  which  to  woi'k'. 

SUMMARY  FOR  CHAPTER  VII 
The   Selection   of  Proper  Wax 

1.  Wliat  is  a  wax? 

2.  Whrit  nro  the  prf)|K'rt  ics  ri  wsix  iimst  possess  to  iiialu'  it  suitable  for  inlay 
jmrposos? 


CHAPTER  VIII 

MAIviXd  AND  CARVING  OF  THE  WAX  INLAY  BY  THE 
USE  OF  THE  DIRECT  METHOD 

Tlie  ^vax  may  ))e  ])rouf;lit  to  the  j^i'oper  state  of  plasticity 
])y  (li  y  or  moist  lieat,  ^nniter  care  l)einf;'  necessary  if  tlie  direct 
(lame  is  used. 

Until  an  automatic  wax  warmer  made  on  correct  principles 
is  readily  obtainable,  hot  water  heat  is  to  be  preferred  and  a 
serviceable  wax  warmer  and  softener  may  l)e  made  by  taking  a 
small  glass  with  a  diverging  or  flaring  mouth,  and  fitting  into 
it  a  cork  of  a  size  that  will,  upon  j^artly  descending  into  the 
glass,  also  act  as  a  cover  to  retain  the  heat  present  there. 

Bankers'  pins  are  inserted  into  the  cork  and  are  allowed 
to  so  penetrate  it  lliat  tlie  points  will  reach  into  the  hot  water. 
The  cones  of  wax  are  then  speared  upon  these  pins,  and  the 
cork  carrying  the  pins,  which  in  turn  carry  the  wax,  is  now  al- 
lowed to  drop  into  the  glass  containing  the  water  at  a  temj)era- 
ture  of  140°  F. 

The  wax-laden  cork  will  float  and  will  allow  the  hot  water 
to  pUiy  around  the  impaled  wax  and  evenly  soften  it.  , 

A  wire  loop  or  glass  pin  j^ush  button  j^laced  upon  the  top 
or  outside  of  the  cork  will  facilitate  the  handling  of  it.  In 
a])out  two  minutes  the  wax  will  be  ph^stic  enough  to  be  used. 

It  is  now  removed  from  its  i)in,  and  with  the  pressure  of 
thumb  or  index  finger  it  is  forced  into  the  cavity.  The  pres- 
sure is  to  be  exercised  in  one  direction  only  and  that  is  in  the 
direction  of  the  floor  and  perpendicularly  to  the  walls  of  the 
cavity. 

While  the  wax  is  being  forced  into  the  cavity,  luhricated 
ir'ifh  a  soJution  of  ca^ior  oil  and  gli/ceriue,  half  and  half,  it  will 
gradually  begin  to  stiffen;  and  when  the  finger  or  thumb  has 
llattened  tlie  sui'])lus  of  it  against  the  tooth  surface,  a  stream 

131 


CAST  C;()L1»  AND  TOKCELAIX  IXLAYS 


Fi<r.   ]4i). — 'J'lic   Ta;j"art  autoinatic   wax   Avainier. 


DIIIKCT    .MK'I'lloD    ol'    ( 'Ai;VI  .\(  i    WAX     I^•|.A^• 


Desckii'Tiox  of  Tack.'akt  Actomatic  Wax  WAKMf:K 
(Sec    opposite    page) 

''This  iiist  niiiK'iit,  an  automatic  wax  waniici',  litis  ;is  a  lieat- 
iiig  element  a  IC-eandle-powcr  lamp,  with  a  carbon  filament.  The 
carbon  filament  is  being  abandoned  for  lighting  purposes,  because 
it  furnishes  more  heat  than  light.  The  Tungsten  filament  fur- 
nishes more  light  than  it  does  heat.  For  that  reason  I  have  used 
the  carbon  filament  to  furnish  the  heat. 

"The  principle'  on  wliich  it  works  is  this:  We  have  here  a 
glass  disc,  which  we  can  turn  to  one  side  in  order  to  place  our 
wax  on  it-  On  account  of  tlie  heat  all  coming  from  one  direction, 
a  metal  disc  or  surface  that  was  flat  would  receive  heat  upon  its 
upper  surface,  and  the  under  surface  of  the  wax  would  be  cool. 
I  found  that  one  of  these  disc  glasses  is  thiu  enough  so  that  as 
the  heat  strikes  it,  it  is  reflected  back  so  that  the  under  side  of 
the  wax  is  warmed  as  well  as  the  upper.  I  have  had  wax  on  here 
for  fifty-six  liours  at  a  time,  and  when  I  examined  it,  it  was 
pisatic  in  its  mass,  and  no  more  heated  on  the  upper  than  on  the 
lower  side. 

' '  The  electric  heating  apparatus  was  hard  to  control  auto- 
matically if  the  current  was  allowed  to  go  in  a  continuous  path, 
but  by  adopting  the  princijjle  I  have  used  here,  of  having  the 
lieat  all  on  or  all  off,  it  permits  the  intermittent  heating  of  a  ther- 
mostat. It  heats  the  thermostat,  and  as  soon  as  it  gets  a  little  too 
warm  it  breaks  the  electric  circuit.  As  soon  as  th?  electric  circuit 
is  broken  the  thermostat  begins  to  cool  down,  and  the  thermostat 
throws  the  current  into  tJie  lamp  again.  It  works  by  excessive 
heat,  aud  it  shows  there  is  not  a  one-hundredth  degree  of  differ- 
ence in  temi>erature  between  the  surface  on  one  sid?-  or  the  other. 
Sometimes  it  will  flash  50  or  60  times  in  a  minute;  sometimes 
slower.  The  reason  is,  it  is  a  very  sensitive  test  of  the  voltage 
that  is  passing  through  the  wire.  You  hava  often  noticed  that 
when  the  lights  would  go  up  high  it  would  make  your  room  light 
enough.  When  the  current  is  at  a  high  voltage  the  lamp  is 
heated  more,  and  that  works  the  thermostat  quicker  and  as  soon 
as  it  is  worked  quicker  it  immediately  drops  down.  The  dancing 
you  see  is  worked  hy  that  voltage. 

"The  wax  is  placed  on  this  glass  disc  and  the  even  tem- 
perature throughout  the  whole  mass  has  a  great  deal  more  to 
ill)  with  the  correct  molding  of  wax  in  a  tooth  cavity  than  you 
tliiiik.  It  is  peculiar,  but  a  soft,  wobbly  condition  of  the  surface 
of  wax  will  invariably  make  it  shrink  from  the  cavity  walls; 
whereas,  if  you  have  a  wax  of  uniform  texture,  it  will  move  to 
its  place  in  an  exact  way,  and  there  will  be  no  change  in  form 
M-hen  it  cools  off."     (Taggart — Itmis  of  Interest,  June,  1911.) 


134 


CAST  COLD  AND  POUCKLAIX  INLAYS 


of  cold  water  is  dirocted  uinm  it  and  the  force  \vliicli  compelled 
it  to  assume  its  new  shajje  is  removetl. 

An  explorer  may  now  be  inserted  into  the  body  of  the  wax 
iuhiy  and  it  inay  be  Avithdrawn  to  be  carefully  examined. 

[['  tile  wax  was  in  tlie  ])roper  plastic  condition,  and  all 
directions  liave  l)een  cai-efully  followed,  the  wax  inlay,  if  the 
cavity  be  simple,  will  be  a  perfect  impression  of  the  cavity,  and 
it  may  be  replaced  in  tlie  tooth  to  assume  its  final  shape,  wdiich 
will  he  a  i^erfect  wax  complement  to  the  macroscopic  anatomy  of 


Fig.  147. — A  glass  of  water  at  a  temperature  of  140°  F.  A  largie  cork  carry- 
ing two  banker's  pins  upon  which  two  pieces  of  inlay  wax  are  impaled.  A  pin  to 
serve  as  a  hanrlle  inseited  into  the  upper  surface  of  the  cork.  The  two  pieces  of  wax 
arc  constaiitly  submerged  in  the  water.  The  cork  seals  the  glass  and  ket'ps  the 
temperature  more  or  less  foii>t;uit  fni    an  :iji]ircciiililc  b  iigtli   ol"  time. 


the   tooth,   and    which   shape   is  ci-catcd    with    caiwers  and    hui'- 
nishers  ol'  the  dirfcrcnt  i)att('i'ns  illustrated. 

A\itli  a  jjeJlet  of  cotton  dipjxMl  into  oil  of  cajeput  or  alco- 
hol, and  de])j-ive(|  of  most  of  its  oil  or  contents  l)y  rolling-  the 
jx'lh-t    in  a  towel   oi-  najjlvin,  the   wax   inlay   is  liindly  ])olislied, 


DIKKCT    .MKTIIOl)    OK    CAKVlXd    WAX    IXLAV  135 

care  bcin^'  cxci-ciscd  to  al\va\s  ])()lisli   towards  ilic  iiiar^'Iiis  of 
the  cavity. 

A^'aiii  lliu  e\j)loi'('i-  is  inserted  into  the  l)ody  of  the  wax, 
midway  Itetweeii  all  margins,  and  tlie  wax  iiday  is  removed 
from  the  mouth,  to  he  transferred  to  a  ^lass  of  cohl  water  until 
it  can  he  suri'ouiKhMl  witli  and  imhe(hied  in  tlie  refractory  com- 
|)oun(l.  In  a  vei-y  (hdicate  wax  inhiy,  it  is  wisei'  to  use  com- 
pressed air  to  I'emove  it  from  its  seat  in  the  cavity;  this  can 
readily  he  done  hy  aj)|»lyin;i'  the  hlast  of  ail-  at  the  cervical  ])art 
of  the  inlay. 

In  com])()un(l  ca^■ities  the  technic  ol'  ])re])ai-in^'  the  wax  for 
the  making'  of  the  wax  inlay,  is,  of  course,  the  same,  except  that 
the  tooth  is  Ijanded  in  extremely  lar<;e  restorations,  wlien  it 
])econies  necessary  to  join  two  or  more  of  the  cones  of  wax  in 
order  to  ol)tain  a  piece  large  enougli  for  the  inlay,  and  some 
surplus  against  which  to  ap])ly  the  force. 

AVhen  this  hecomes  necessary,  two  cones  of  tlie  softened 
wax  ai-e  hrought  together  at  their  hase,  and  a  hot  spatula  is 
drawn  longitudinally  through  hoth  cones  at  four  or  five  places 
on  the  cii'cumference,  and  twice  through  the  joints  of  the  cones 
horizontally.  This  will  result  in  an  iiiseparahle  piece  of  inlay 
wax  twice  the  nsual  size. 

If  the  ])iece  has  stiffened  too  nuich  in  the  process  of  han- 
dling, it  is  again  impaled  upon  the  pin  and  placed  in  the  hot 
water  to  ])ecome  properly  i^lastic. 

The  large  piece  of  wax  is  now  removed  from  the  water 
hath  and  forced  into  the  cavity,  care  heing  taken  to  exercise  the 
pressure  in  one  direction,  that  of  the  floor  of  the  cavity,  and 
jjerj^endicularly  to  the  walls  of  it  and  the  hand  which  sur- 
rounds it. 

The  wax  will  giadually  cease  to  yield  to  the  ijressure,  and 
while  the  force  is  still  in  place,  the  wax  must  be  cliilled  with  a 
stream  of  cold  water. 

In  this  manner  the  handling  of  wax  is  hrought  ahout  under 
pressure,  and  thus  the  shrinkage  and  exjjansion  of  waxes,  so 
much  talked  and  written  ahout,  and  Avorked  up  into  red  letter 
scareheads  ))y  investigators  who  shoot  off  at  a  tangent,  really 
deserve  no  consideration  at  all  if  the  technic  laid  down  hy  the 
oi'iginator  of  the  ])rocess  he  followed  to  the  letter. 


13G  CAST    (!OLI)    AXli    roltC'ELAI  X     IXLAVS 

To  r('i)(  at  a  ])()iiit  to  Ix'  carcriilly  oLsc'iaimI:  llic  casu'sl  way 
\o  make  a  wax  inlay  foi-  coinpoiiiKl  oi-  (•()iiij)lex  cavities  is  to 
convert  tliem  into  sini])]e  cavities  1)y  placin^;'  a  copper  hand  over 
and  around  tlieni. 

These  hands  may  1)e  made  uj)  in  (piantities  out  of  sheet 
copper  36-gauge  B6:S  and  kept  on  Inuid,  or  a  matrix  such  as 
ilhistrated  in  Figs.  149  and  150  may  he  used. 

Tlie  case  presenting  itself,  a  ])and  of  suital)le  size  is  selected, 
triimned  to  gingival  contour,  and  j^laced  over  the  tooth  after 
tlie  cavity  has  heen  prepared. 

The  softened  wax  may  then  he  forced  into  the  cavity  against 
the  walls  of  the  ])and,  the  pressure  may  then  he  removed  and 
a  stiff  cone  of  wax  may  1)e  forced  into  the  mass  within  the  hand, 
the  center  of  the  mass  having  hi-st  l)een  softened  with  a  suitahle 
hot  instrument. 

It  may  he  well  to  reiterate  here  that  the  wax  is  thoroughly 
plastic  that  is  foix-ed  into  the  cavity,  the  jiressure  heing  ex- 
ered  in  one  direction,  and  that  w  Idle  the  force  is  still  upon  and 
hehind  it,  it  is  greater  tlian  the  force  acting  upon  the  molecular 
structure  of  the  wax  in  its  attempt  to  shrink  or  alter  its  form; 
thus  the  deleterious  i)art  of  tlie  shrinking  force  or  tendency 
will  he  overcome,  and  the  result  will  he  a  wax  filling,  occupying 
every  part  of  that  cavity  and  ahutting  all  margins  accurately. 
It  again  hecomes  a  c[uestion  of  two  forces  acting  in  opposite 
directions  u])on  a  nioval)le  hody  (the  wax),  and  it  nuist  he 
clearly  seen  that  the  greater  force,  if  ])roperly  applied,  Avill 
prevent  any  change  of  form  in  the  wax,  in  the  wrong  direction 
after  it  has  induced  it  (the  wax)  to  assume  a  certain  definite 
shape;  to-wit,  that  of  tlie  cavity. 

At  tliis  time  the  vai'ious  margins  occupy,  or  should  occupy, 
the  oj)erator's  entire  attention.  Willi  llic  pi-o])er  carvers,  all 
margimd  surplus  of  wax  is  icnioNc*!.  With  light  and  left  hur- 
nishcrs  and  al\\a\s  in  direclion  of  the  xarious  margins  that  ])art 
of  the  wo]"k  is  completccl  licroic  we  proceed  with  the  carving  of 
tlie  occlusal  suiTacc  in  oiih'i'  to  restore  occlusal  halance. 

A  lai"ge  hall  f)r  egg-sliapc(|  huinisher  is  heated  in  Ilic  gas 
or  ah'ohol  Ihinic,  or  i1  nia\'  he  aUachcd  lo  the  swilchhoard,  and 
the  occlusal  sui-facc  of  the  wax  iiilax',  reeling  in  the  cavity,  is 
softened  sufficiently  lo  enahlc  llic  paticnl   lo  occlude  and  Iritu- 


DIIJKCT    MKTIIOI)    Ol'    ('Ai;VIX(i    WAX     IXI.AV 


r.v> 


Fig-.  148. — A  spatula,  a  set  of  right  and  left  and  straight  flat  burnisher! 
right  and  loft  carvers,  and  hand  drills  used  by  the  author. 


lancets, 


138  CAST    CiOLD    AND    PORCELAIN    IXLAYS 

rate;  it'  the  Avax  l)e  lackiii<;'  in  l)ulk,  a  i)ortion  may  be  added. 

J 11  tlie  case  of  an  inlay  for  a  ]o^vel•  tooth,  we  simply  i)lace 
a  ])ieee  of  inlay  wax  upon  tlie  occlusal  surface  of  the  wax  inlay, 
and  with  tlie  hot  burnishers  the  two  waxes  are  united. 

In  an  upper  case,  it  is  advisable  to  first  soften  the  occlusal 
surface  of  the  wax  inlay  in  place,  and  then  carry  an  additional 
piece  of  the  wax  into  the  softened  surface.  The  union  is  coni- 
2)]eted  by  again  using  tlie  hot  instrument  and  virtually  melting 
the  added  jjortions  into  the  wax  inlay. 

AVhen  the  required  bulk  is  obtained,  and  sufficiently  sof- 
tened, the  patient  is  allowed  to  occlude  and  to  triturate,  and 
again  to  simply  occlude  and  hold  that  position  while  a  stream 
of  cold  water  fixes  the  wax. 

Xone  but  the  occlusal  surface  will  undergo  any  change,  all 
margins  will  be  found  undisturbed,  since  the  softening  process 
was  not  carried  to  any  marginal  jJortion. 

AVlien  the  maxillary  tension  is  removed  and  the  mouth 
opened,  the  i^roj^er  landmarks  for  occlusal  carving  will  be 
clearly  indicated  and  must  be  rigidly  adhered  to,  if  an  occlusal 
surface  that  will  be  truly  serviceable  in  the  full  sense  of  the 
word  is  to  be  obtained. 

SUMMARY  FOR  CHAPTER  VIII 

Making  and  Carving  of  the  Wax  Inlay  by  the  Use  of  the  Direct  Method 

1.  DcsciiljL'  a  iiu'thofl  of  bringing  the  wax  to  the  proper  ntate  of  plasticity 
l)y  moist  lieat. 

2.  Describe  the  method  of  making  the  wax  pattern  if  tlie  cavity  is  a  simple 
one. 

'.I.  Explain  tlio  details  of  preparing  tlic  pattern  for  conij)ouiid  or  cuin}ilex 
cavities. 

4.  Describe  the  finishing  of  the  margins. 

~).  Describe  tlio  teclinic  of  carving  the  pattern  to  icstorc  the  occlusal   surl'acc. 


CIIAP^rKK'   IX 

TAKIX(i   AX  I.MPRESSIOX  OF  TIIK  (\\V1TY  AND 

MAKTX(i  A  J)TE  FOll  PROCM^yOlK'K  in'  TTIK 

IXDlirFAT  METHOD 

'riic  |)i-()l)l('iii  of  making'  a  east  ^old  iiila\-  l)y  iiicaiis  of"  llie 
imjn'ession  or  indirect  method,  should  really  not  be  considered 
as  a  j)rol)lem  l)y  itself,  l)ecause  as  such  it  at  joresent  admits  of 
no  solution  worthy  of  the  name. 

If  used  at  all,  it  should  prove  hut  an  accessory  step  in  the 
direct  methoil,  and  so  be  employed  in  cavities  so  inaccessible, 
and  under  circumstances  so  remote  that  the  infrequency  of  these 
stipulations  shall  in  themselves  exclude  it  from  the  routine  of 
daily  work. 

Some  disto-occlusal  cavities  in  the  third  molars  may  call 
for  the  indirect  method  as  an  aid  to  the  direct,  but  under  no 
circumstances  should  sufficient  reliance  be  placed  on  an  im- 
pression of  sucli  a  cavity  to  complete  the  inlay  uj^on  a  die  made 
from  this  impression,  without  giving  the  wax  its  final  shape  in 
the  cavity  itself. 

The  very  name  which  the  advocates  of  this  method  have 
given  it,  namely,  the  indirect  method,  in  itself  stamps  it  as 
something  remote,  far  off;  labor  and  time  and  energy  are 
wasted  in  attempts  to  have  an  assistant  assume  that  j^art  of 
the  constructive  work  in  the  laboratory  which  should  be  done 
right  in  the  mouth. 

These  advocates  who  claim  satisfactory  results  from  their 
])rocedure,  are  being  misled  by  burnished  margins  of  their  in- 
lays; they  lose  all  frictional  relation  between  their  product  and 
the  cavity  it  is  to  occupy,  but  they  honestly  overlook  the  fault, 
grave  though  it  be,  l)ecaus(^  the  method  shifts  res])onsibility  to 
give  time  to  work. 

The  fact  is,  that  if  no  better  inlay  could  l)e  made  than  the 
best  Avliich  have  been  made  u])  to  date  by  means  of  the  indirect 

139 


140  (AST    (lOLl)    AXO    POPvCELAIIs^    INLAYS 

iiietliod,  llu'  entire  ])i-ot'ess  of  cast  gold  inlays  would  be  a  medi- 
ocre ])alliative  measure,  instead  of  the  greatest  boon  to  the 
dentistry-requiring  jjublic,  and  if  that  had  been  the  best  it  were 
]Kissible  to  obtain,  I  doubt  nuich  if  it  would  ever  have  been  given 
to  the  profession  at  all. 

The  first  stej)  in  the  construction  of  an  inlay  is  to  take  a 
perfect  impression  of  the  properly  prepared  cavity.  If  the 
direct  method  is  to  be  employed,  that  impression  must  be  taken 
in  the  inlay  wax.  If  the  indirect  method  is  to  be  emj^loyed,  the 
initial  impression  is  taken  in  a  modeling  compound,  preferably 
"Detroit." 

The  most  j)ersistent  argument  of  the  advocates  of  the  in- 
direct method  is  that  they  can  not  get  a  proper  pattern  of  the 
cavity  in  using  the  direct  method;  in  other  words,  they  can 
not  get  a  j^erfect  impression  of  that  cavity  in  inlay  wax. 

If  that  be  true,  how  does  it  liaj)pen  that  they  can  get  what 
they  consider  a  perfect  impression  in  a  compound,  not  nearly 
so  relial)le  in  its  physical  i^roperties  as  is  the  Avax  they  should 
use. 

AVlien  tlie  direct  method  is  emx)loyed,  the  margins  of  the 
cavity  in  the  tooth  are  an  ever  present  help  to  thorough  Avork, 
and  an  ever  jjresent  deterrent  to  the  slip-shod,  just-as-good 
results. 

Once  the  margins  are  obtained,  the  major  j)art  of  the 
carving  may  be  done  outside  of  the  mouth,  and  the  wax  inlay 
replaced  from  time  to  time  to  insure  correctness  of  manipu- 
lation. 

Proper  occlusion  may  be  obtained  beyond  the  question  of 
a  doubt,  and  tliat,  without  the  additional  work  of  taking  an 
additional  ])ite  in  a  filmy  piece  of  wax,  and  without  taking  an 
imjnx'ssion  of  the  affected  tooth,  can-ying  the  com])ound  impres- 
sion of  the  cavity,  and  of  the  surrounding  area  for  a  guide  to 
the  desired  correctness,  and  often  that  is  as  far  as  one  can  get 
to  the  con-cct  r(  suit,  ergo  the  desire  for  it. 

The  answer  is  made  that  while  all  of  these  stei)S  are  nec- 
essary, they  may  he  done  in  llie  laboratory,  and  here  the  great 
mass  of  errors,  A\hicli  Inllow  liic  nse  of  such  materials  as  com- 
pounds, jjlaster,  amalgams,  variation  in  mass,  temperature,  and 
j)hysical  strnctni-e  in   the  hands  oF  a   lahoratorx'  assistant,  who 


TAKIXC     IM  I'KKSSIOX    AND    MAKIX.)     DIK 


141 


can  only  begin  working  upon  and  with  these  materials,  after 
the  errors  have  crejjt  in,  all  combine  to  give  a  result  not  looked 
for,  and  this  result  is  made  to  assume  a  semblance  to  tlie  one 


Slide 


Fig.  1-19. — The  upper  figure  shows  a  piece  of  sheet  copper  33-  or  36-gauge, 
cut  as  illustrated.  The  lower  figure  shows  the  same  piece  of  copper  formed  into  a 
band  and  locked  by  bending  surplus  back  upon  itself.  Note  at  aa  two  vertical  and 
two  horizontal  cuts  to  allow  the  improvised  band  to  be  forced  apart  in  order  to  ob- 
tain contact  witli  adjacent  teeth. 


Fig.  1.50. — niustiating  a  handy  matrix  in  position  upon  a   molar. 


I       / 


looked  for  by  using  the  burnishers  freely,  and  the  good  or  fairly 
good  margins  deceive  most  of  us. 


1-12  CAST    COLD    AXD    PORCELAIN    IXLAYS 

They  wlio  adiiiil  tlicir  incapal)ility  to  make  an  accurate 
impression  of  a  ca\ity  in  inlay  wax,  luwe  never  familiarized 
themselves  Avitli  its  i)liysical  i)roperties,  and  should  start  right 
there.  Let  them  study  the  wax,  its  physical  properties  under 
various  temperatures,  its  adaptability,  its  toughness,  etc.  AVork 
it  carefully,  use  it  as  if  it  Avere  something  alive,  vibrant,  re- 
sponsive; for  it  has  in  it  all  the  things  that  give  life  and  re- 
s])onsiveness,  put  there  by  a  very  inspiration.  Then  let  these 
indirect  method  men  comj^are  their  results  of  the  time  at  hand 
and  the  time  past. 

The  advocates  of  the  indirect  method  obtain  an  impression 
of  the  cavity  for  wliidi  they  expect  to  make  an  inlay,  and  they 
construct  a  die  upon  and  into  this  impression.  The  result  is  a 
l^artial  model  of  the  tooth  to  be  inlayed,  the  partial  model  being 
made  of  amalgam  or  cement,  i^referably  the  former. 

Some  proceed  to  form  the  wax  inlay  in  this  very  die,  which 
is  ecpuvalent  to  making  a  complement  to  the  human  anatomy 
Avithout  having  that  part  Avhich  is  to  receive  the  complement 
before  you  in  its  entirety.  They  guess  at  bulk,  Avidth,  length 
and  contour,  and  if  they  guess  correctly,  tlie  indirect  metliod 
is  a  success  and  they  proceed  to  giA^e  it  to  those  Avhom  they 
designate  as  the  rank  and  tile  of  their  profession. 

XoAv,  let  me  ask  this  of  the  rank  and  file  and  laymen: 
AVhat  Avould  Ave  be  likely  to  think  of  a  man  Avho  tried  to  supjDly 
a  part  of  one  finger  of  a  hand  Avithout  having  the  Avhole  of 
that  hand  before  him  all  through  the  operation?  AVould  Ave 
consider  him  correct?  Of  course  not,  l)ecause  he  Avill  liave 
consti'ucted  the  complemental  portion  Avithout  due  reference  to 
tlie  wliole;  Avithout  having  at  his  disposal  a  comprehensive  vicAv 
of  that  with  Avliich  the  complemental  part  must  ever  interplay 
and  hai-monize,  and  so  the  least  these  indirect  method  advocates 
can  do  is  to  have  before  them  a  complete  model  of  the  tooth. 
Some  of  them,  realizing  this,  obtain  a  Avax  bite  (indefinite 
and  inaccurate),  and  so  to  speak,  plant  this  die  into  the  Avax 
bit*',  filling  in  tlic  rest  oF  it  willi  plaslci-.  Too  often,  almost 
always,  a  mici-osco])i('  shin  Ink'cs  place,  nnd  innl1inii('roscoi:)ic 
errors  are  the  I'esult, 

Tliey  are  also  ])roii('  to  lunp  upon  llic  suhjcci  of  gold  and 
porcelain    inlays,   as   if   Die   jx'olilcms   wo-c   one,    ignoring  pnr- 


TAKIXC;    JMPKE.SSIOX    AXI)    .MAI':iN(;    DIE  148 

J30sely  or  otlici-wisc,  the  fact  that  llici-c  is  no  coiii])arisoii  ]>('- 
tween  the  two,  cxcci)!  that  both  act  as  lilliii<^'s  or  inlays  for  a 
tooth. 

Tlic  i)r(>i)ai'ati()ii  of  the  ravit>-  is  wholly  different;  the  phys- 
ical [)r()|)erties  of  the  matei'ial  aic  wholly  <litTerent;  tlie  nietliod 
of  construction  after  obtaining'  ini])ressioii  and  die  is  wliolly 
different;  and  the  i)roblenis  or  ohstack's  in  the  way  of  niakin<;- 
i:)orcelain  inlays  for  posterior  teeth  ])y  the  use  of  the  direct 
method,  are  many  times  <;reatei'  than  when  we  are  workinft- 
in  <;'old. 

So  in  justice  to  tliemselves  and  the  art,  and  tor  the  sake 
of  those  wlio  read  and  wisli  to  learn,  they  should  l)e  more  care- 
fully accurate  in  tlieir  statements,  and  less  confusing  to  the 
learner.  They  sj^eak  of  the  advantage  of  the  indirect  method 
in  case  of  failure  at  the  time  of  casting,  ignoring  tlie  fact,  that 
they  (with  emphasis  on  the  they)  have  a  failure  as  the  result 
of  every  so-called  successful  casting. 

If  they  tested  the  machine  before  every  casting;  if  they 
were  always  careful  to  proj^erly  ndx  the  investment,  and  to 
always  duplicate  that  proper  mix;  if  they  took  tlie  time  to 
learn  how  to  properly  manipulate  the  wax;  if  they  were  careful 
to  note  the  boiling  ])oint  of  the  gold  they  were  using  for  their 
casting,  which  is  considerably  different  from  the  fusing  point; 
assuming  that  all  their  materials  were  clean;  and  if  with  all 
the  foregoing,  they  used  the  direct  method,  they  would  not  need 
to  consider  the  possil)ility  of  failure. 

They  say  that  the  "Great  Taggart"  (and  they  are  care- 
ful to  say  "great"),  and  a  few  of  his  closest  followers  perhaps 
(note  the  perhaps)  can  do  the  work  by  the  direct  method,  and 
show  perfect  results;  thus  convicting  themselves  by  the  ad- 
niission  that  they  have  not  followed  the  (Jreat  Taggart.  Thus 
they  admit  the  perfect  results  of  Taggart  and  his  close  fol- 
low^ers,  but  they  want  the  rank  and  file  of  the  profession  to 
follow  thcDi,  even  though  they  qualify  their  results  as  but  fairly 
accurate. 

If  Taggart  obtains  perfect  results  (which  they  admit),  and 
if  the  close  followers  of  Taggart  obtain  i:)erfect  results,  and  if 
it  is  perfect  results  they  are  trying  to  obtain,  clearly  the  easiest 
and  surest  wav  is  for  them  to  follow  the  directions  thev  have 


144 


CAST    COLD    AXI)    rOIlC'K.CA  I X    IXLAY8 


])eeii  persisteiith'  tryin,!;-  to  coiit'uso  and  o])s('iiiv  Tor  the  rank 
and  tile  oi'  the  profession. 

Tliey  are  of  course  ^vasting  tlieir  time,  and  the  time  of  tliose 
wlio  follow  tlieir  indirect-method-ward  jDointing  index  finger, 
and  it  may  not  jDlease  them  much  to  contemplate  the  fact  that 
a  waste  of  time  is  a  waste  of  life. 

AVe  shall,  liecause  of  the  foregoing,  take  up  the  indirect 
method  of  making  a  wax  inlay  onl_y  as  an  accessory  to  the  di- 


Fia-.  1.51. 


Fisr.    152. 


Figs.  151  and  152. — Hinged  trays  designed  and  constructed  by  the  author  for 
taking  correct  impressions  of  niesio-disto-occlusal  cavities  and  teeth  ui^on  which 
they  present. 


Fig.    15.3. — Disto-occlusal 
cavity  tray. 


Fig.   154. — Mesio-ocflusal 
cavity  tray. 


Fig.    155. — Hinged    tray 
for  anterior  teeth. 


rect,  remembering  that  the  wax  Jimst  he  gi\('ii  its  filial  slia])e 
and  fitting  in  the  tooth  cavity  itself. 

Willi  tills  ("lid  in  \i('\v,  the  hinged  and  jH'rforated  trays 
liere  illustrated,  were  constructed  in  their  various  sizes  and  in 
respect  to  the  tooth  forms  for  which  they  were  made;  they  are 
universal  in  application. 

There  are  ten  trays  for  the  iip|»cr  inoiai's,  di\'i(hMl  as  fol- 
lows: 


TAKING    l.M  PUKSSIOX    AND    MAKIX(;    ])I1': 


145 


Two  i'i,<;lit  iipjx'i-  Tor  (lislo-occlusal  cavities. 

Two  right  ujjijer  for  ine.sio-occlusal  cavities. 

One  right  ui)2)er  for  mesio-disto-ocehisal  cavities. 

One  for  riglit  upper  bicusi)itls  I'or  disto-oecliisal  cavities. 

()iK'  I'or  fight  ii))])er  bicuspids  for  niesio-occlusal  cavities. 

()ii('  I'oi'  right  u])p('r  l)icus])i(ls  for  iiicsio-disto-occliisal  cav 


ilies. 


Fig.  I-'jG. — Hiiigod  tray  in  position.     Impression  of  roesio-disto-occhisal  cavity  partly 

completed. 


Fig.   1.37. — Hinged  tray  in   closed  position.      Completing   impression   of   mesio-disto- 
occlusal  cavity  and  tooth  upon  which  it  presents. 


Several  hinged  trays  in  tliree  sizes,  as  illustrated,  are  made 
for  use  upon  anterior  teeth,  when  occasion  presents  itself. 

These  trays  enumerated  for  the  right  upper  are  duplicated 
for  the  left  side  of  the  superior  maxilla,  except  that  the  trape- 
zoidal angles  are  changed  to  conform  with  the  requirements. 


14(j  CAST    (lOLD    AND    roi;CKI>AIX    J^s'LAV.S 

Only  half  of  tlio  nmnher  of  trays  is  required  for  the  lower 
molars;  for  wliai"  Avill  serve  as  a  disto-occlusal  tray  on  the  right 
side,  may  be  used  as  a  niesio-oeclusal  on  the  left;  and  so  hut  two 
mesio-oeclusal  and  two  disto-occlusal,  and  one  mesio-disto-occlu- 
sal  tray  for  the  molars,  will  he  necessary. 

"\Ve  shall  need  one  niesio-occlusal  and  one  disto-occlusal  tray 
for  the  second  bicuspid  and  the  same  number  for  the  first  lower 
bicusijid  right  and  left.  Two  sizes  of  hinged  trays  for  each 
anterior  lower  tooth  may  be  made.  Right  and  left  being  inter- 
changeable, only  six  trays  will  be  required  for  that  region. 

AVlien  it  becomes  necessary  to  obtain  a  reliable  impression 
of  a  properly  prej^ared  cavity,  the  corresponding  tray  is  se- 
lected and  that  joart  of  the  tray  which  is  contiguous  or  not 
hinged,  is  tilled  with  a  small  amount  of  modeling  comj)osltion, 
softened  in  the  Bunsen  burner.  Care  is  to  be  exercised  not  to 
burn  the  comj^ound. 

The  two  hinged  and  lubricated  portions  of  the  tra}^  are  in- 
verted and  used  as  a  handle. 

The  compound-carrying  tray  is  now  carefully  brought  over 
the  tooth  and  centered;  then  with  a  direct  pressure  ujoward  or 
downward,  as  the  case  may  l)e,  the  cavity  is  filled,  and  that  part 
of  the  tooth  enveloped  in  the  soft  compound. 

Because  of  the  unyielding  tray,  the  impression  material  will 
be  forced  against  the  margins  of  the  cavity,  while  the  surplus 
will  be  expelled  buccally  and  lingually. 

The  two  hinged  wings  of  the  tray  j^reviously  lubricated, 
are  quickly  closed  upon  the  buccal  and  lingual  sides  respectively, 
and  the  surplus  of  the  comi)ound  is  held  against  the  tooth  under 
pressure. 

A  stream  of  cold  water,  directed  Ti])on  the  tray,  will  chill 
the  compound. 

The  liiiigc*!  wing  upon  ilic  lingual  or  palatine  surface  is 
again  in\('r1('(|,  the  sui'plus  (•()iupoun(l  is  cut  away  with  a  sharp 
lance;  llial  ^ufface  of  the  tooth  is  lubricated  with  some  white 
vaseline;  a  small  piece  of  softened  im])i'ession  material  is  placed 
ui)on  the  inner  surface  of  the  wing  of  the  tray,  and  while  the 
lattei-  is  firmly  held  in  position,  the  Fornier  is  closed  <lown  u])()n 
the  tooth  surface,  an<l  niodei'ate  ))j'essure  is  applied. 


TAKIXC     I.MIM'.KSSIOX    AXI>    .MAKINC    |)IK 


147 


A  sticaiii  of  cold  waliT  will  accclcraic  \\\v  liai-dciiiii^'  of  that 
surface,  and  llu'  hinged  win^'  u])()ii  tiic  Iniccal  surface  is  sub- 
jected to  the  same  iiiauiijulalioii;  lliat  is,  it  is  inverted,  the  sur- 
l)lus  cut  away,  the  toolli  surface  is  luWricated,  and  a  ])iece  of 
sol'teiR'd  inij)r('ssi()ii  material  is  jjlaccd  iij)()n  tlic  liin,i;(Ml  sui-face, 
\vheu  it  is  a^'ain  rcinNcrted  and  forced  to  place.  A^ain  a  stream 
of  cold  water  accelerates  hardening-  of  the  compound. 

Wliatever  sui-])lus  of  comjjound  may  sliow  giu^ivally,  may 
he  femoved  witli  a  sliaij)  huice,  and  we  are  now  I'eady  to  ol)tain 
an  impression  of  the  surrouudin*;-  teeth,  a  model  fi'om  whicli 
im|)ression  may  ^ive  us  our  cavity  and  its  ri^ldful  environment. 

It  will   he  necessary  to  keep  the  saliva  ejector  in  the  pa- 


Fig.   158. 


FiiT.   159. 


Fig.  158. — Coniijletc  impression  of  tooth  and  eavityomljcdilod  in  idaster  im- 
pression of  adjacent  teeth,  ready  for  the  packing  of  amalgam  die. 

Fig.  159. — ConiplotP  impression  of  tootii  and  cavity,  removed  from  the  mouth. 

tient's  mouth,  in  order  to  carry  off  the  water  used  in  chillin<;' 
the  compound. 

A  unilateral  tray  for  the  particular  side  of  the  mouth  is 
selected.  A  mix  of  plaster  of  Paris,  of  the  consistency  of  thick 
cream,  is  put  into  it,  and  the  tray,  plus  i3laster,  is  quickly  car- 
ried to  the  side  of  the  nioutli  and  carefully  foi'ced  to  i^lace. 

The  plaster  is  given  from  five  to  ten  minutes  to  set,  and 
a  spray  of  cold  air  is  directed  upon  it  while  it  is  setting,  when 
the  cup  is  removed  and  the  plaster  impression  carefully  broken 
away  from  the  tooth.  The  buccal  or  lal)ial  ]wrtion  is  removed 
first,  l)y  placing  the  index  finger  of  one  hand  under  tlie  ^^laster 


]-i8  CAST    tlOlJ)    AND    POIiCELAlN    INLAYS 

buccally,  and  keeping  the  index  linger  of  the  oilier  hand  upon 
tlie  niorsal  surface  of  the  impression. 

Tlie  patient  is  then  directed  to  open  the  mouth  nuicli  wider, 
the  index  finger  under  the  buccal  side  of  the  impression  is  ro- 
tated towards  the  oral  cavity,  and  usually  no  difficulty  will  be 
experienced  in  the  removal  of  that  joart  of  the  impression. 

An  upward  and  downward  pressure  upon  the  lingual  i^art 
of  the  impression  will  readily  dislodge  that  portion  of  it,  and 
so  all  parts  of  the  plaster  may  be  gathered  to  be  again  re- 
assembled in  the  cup  after  they  liave  been  allowed  to  become 
moderately  dry. 

The  compound  carrying  tray  will  be  found  in  perfect  cc- 
dition  upon  the  tooth  requiring  the  inlay. 

All  evidence  of  plaster  is  now  removed,  and  the  outer  or 
buccal  hinged  i^art  of  the  tray  is  again  inverted,  as  is  the  lingual 
or  joalatine. 

Grasi^ing  these  two  hinges,  mesio-distalh%  the  rest  of  the 
imiDression  will  come  out  and  may  be  brought  into  full  view 
outside  of  the  buccal  cavity. 

Again  the  two  hinges  are  jDut  back  into  their  respective 
positions,  and  Ave  shall  have  an  impression  of  the  entire  tooth, 
for  which  we  are  about  to  make  a  metallic  complement. 

Because  of  its  j)eculiar  position  within  the  i)laster  impres- 
sion, the  tray  carrying  the  compound  impression  of  the  cavity 
will  be  immovabl}^  fixed.  More  plaster  is  added  to  the  i)laster 
impression  in  order  to  strengthen  its  w^alls;  all  the  plaster  is 
varnished,  and  we  are  ready  to  pack  the  amalgam  into  the  com- 
pound impression,  so  as  to  form  a  die,  reproducing  the  tooth 
that  requires  an  inlay. 

THE  MAKING  OF  THE  AMALGAM  DIE 

Foi-  tlie  ])Ui-pos('  of  iiiak'iiig  a  die,  (  itlicr  a  silver  or  copper 
alloy  niay  be  used. 

TIk;  wiiter  has  been  able  to  ol)tain  much  more  clearly  de- 
hned  juargins  and  outlines  with  the  copjoer  alloy,  and  would, 
therefore,  commend  it  for  this  purpose. 

It  is  also  ]iiucli  harder  and  not  nearly  so  likely  to  become 
snbjeet  to  distorting  iiKK'ciii'acy. 


TAKIN(i    IMPKESSIOX    AND    INIAKIXf;    DIH  149 

A  quantity  oC  llio  alloy,  vai\vin<;'  directly  as  the  size  of  tlie 
case,  is  placed  in  an  iron  s])()on  and  carefully  heated  over  tlie 
Bunsen  flame  until  the  globules  of  mercury  appear  upon  the 
surface  of  the  small  cojjjx'r  amalgam  l)i-i(piettes. 

The  mercury-exu(rm<;'  mass  is  now  thrown  into  a  AVed^wood 
mortar,  and  tliorou,c,hly  macerated  under  pestle.  This  macera- 
tion is  kept  u})  until  the  mass  seems  and  feels  smooth;  if  the  mix 
appears  thick,  more  mercury  nuist  be  added,  so  that  a  thin  and 
readily  flowing-  nuiss  may  be  obtained. 

The  AVedgwood  mortar  is  now  upset  upon  a  sheet  of 
manilla  paper,  and  with  a  stout,  broad  sj^atula  of  German  silver, 
or  a  polished  steel  knife,  the  amalgam  is  spread  over  the 
largest  possible  area  of  the  i^aper  in  a  thin  film,  and  consid- 
erable pressure  is  use<l  to  make  certain  of  the  smoothness  of 
the  mass. 

AVhen  this  has  been  attained,  the  amalgam  is  divided  into 
three  portions;  the  first  j^ortion  should  be  large  enough  to  cover 
all  margins  as  well  as  the  seat  and  walls  of  the  cavity,  the 
second  portion,  about  twice  the  size  of  the  first,  and  the  third 
portion,  about  again  as  large  as  the  second. 

The  first  portion  is  no^v  put  into  a  piece  of  chamois  and 
twisted  U13  into  a  ball.  A  part  of  the  mercury  is  expelled  by 
twisting  the  chamois,  but  under  no  circumstances  must  too  great 
a  pressure  be  aj^plied,  as  that  would  make  the  mix  unfit  for  use 
at  this  stage. 

Pointed  instruments,  the  j^oints  whicli  have  been  rounded, 
are  then  used  to  place  the  soft  amalgam  in  apposition  to 
every  margin,  wall  and  seat  of  the  cavity,  and  when  that 
has  beeen  accomplished,  smooth  flat  i^lugger  j^oints  are  sub- 
stituted for  the  pointed  instruments,  and  the  amalgam  is  j^atted 
down  into  every  pcn'tion  and  up  to  every  margin  of  the  cavit}' 
impression. 

The  second  portion  of  amalgam  is  now  jnit  into  a  piece  of 
chamois,  and  the  chamois  containing  the  amalgam  is  twisted 
into  a  ball.  A  greater  portion  of  the  mercury  than  Avas  ex- 
pelled from  the  first  jjortion  of  amalgam,  is  now  expelled  from 
the  second  portion;  in  fact  the  latter  must  be  fairly  crisp  to  be 
fit  for  use. 


150 


CAST    (lOLIt    AND    TOItCELAlX     INLAYS 


Large  ball  aud  egg-  .shaped  biiriilsliers  are  used  to  place  this 
erisjD  mass  over  and  into  the  aiiialgani  already  jDreseiit  in  the 
impression.  It  will  be  noted  that  under  constantly  apiDlied 
pressure,  the  newly  added  mass  will  take  up  the  excess  of  mer- 
cury in  the  mass  first  put  into  the  impression. 

Finally,  the  third  portion  of  amalgam  is  put  into  the 
cliainois,  and  subjected  to  the  same  sort  of,  but  slightly  in- 
creased, pressure,  so  that  nearly  all   of  the  mercury  will  be 


rr 


X 


i>^ 


Fig  160. — :N[o(lel  presenting  a  view  of  amalgam  replica  of  tooth  requiring  restora- 
tion in   correct   relation   to   adjacent  teeth. 


rx 


Fig.   161. — Model   lubricated   wi/th   mixture   of   castor   oil    aud   glycerine. 

ex])elle(l  and  ilic  ainalgniii  Ix'coines  (jiiilc  hard  and  l)ut  just 
worl\al)h'. 

AVith  lai-ge,  (hit  padding  iiisl  ruiiiciils  this  mass  is  now  grad- 
ually and  wilh  cotistantl)-  increasing  j)ressure  and  a  rocking 
motion,  put  into  and  onio  llic  I'cst  ol*  the  amalgam. 

The  excess  of  nKTcury,  il'  an\-  he  presetil,  is  now  i'eni()\'ed 
h>-  hurnishing  several  la>(M-s  of  lin  foil  oNcr  the  Hal  sui-face  ol* 
1lie   iiijiss,  and    willi   a    Hal    clilselcnd    iiisl  ninienl,    an    ii'regular 


TAKING    Ii\rrnESSIOX    AND    IVrAKIN(;    DIE 


151 


I'cccss  t'((u;il  ill  (k'])lli  to  nhoiil  oiic-lliii'd  of  its  greatest  (liaiiictcr, 
,is  sunk  into  tlic  mass  of  anial^ain. 

The  i)la.st("r  iin])r(>ssi()n  carryin^j,-  the  hinged  tray  and  coni- 
|)oiind  impression  n\  hich  contains  the  amalgam  wliieli  has  ])een 
introduced,  is  now  h-iid  asich'  for  at  least  twelve  hours  to  give 
the  amalgam  an  ()i)i)()rtiinity  to  thoroughly  crystallize. 

The  next  ste])  shouhl  he  the  immersion  of  the  amalgam- 
carrying  inij)ressi()n  into  water,  and  the  tilling  in  of  the  rest 
of  the  im))ressi()n  with  plaster  of  Paris,  when,  after  three-quar- 
ters of  an  hour  or  one  hour's  time  has  elapsed,  the  imi)ression 
tray  is  freed  from  surrounding  plastei',  the  plaster  impi'ession 
is  carefully  hroken  and  cut  away,  exposing  a  ])laster  cast  carry- 
ing the  hinged  tray  and  com])Ound.     The  cast  is  now  immersed 


Fig-.  162. — Occluded  models  of  case  requiring  restoration.  Note  in  the  upper 
arch  the  amalgam  die  in  correct  relative  position  and  correct  occlusal  relation  to 
the  lowci'   model. 


in  water  at  a  temperature  of  135°  to  140°  F.  for  about  two 
uiinutes,  Avheu  the  hinged  portions  of  the  tray  may  he  easily 
inverted  and  all  of  the  compound  impression  removed  from 
amalgam  tooth  and  cavity. 

We  have  no^v  before  us  a  plaster  cast  securely  carryhig 
a  complete  copper  amalgam  reproduction  of  the  tooth  requiring 
a  gold  inlay,  and  if  the  directions  prescril)ed  above  have  been 
studiously  followed,  the  cavity  in  which  the  wax  inlay  is  to  be 
formed  may  be  used  as  a  w^orking  base  \\\)on  which  the  ])re- 
liminary  carving  may  be  done. 

A  w^ax  bite  previously  secured  from  the  patient's  mouth 
is  now  mounted  upon  the  plaster  cast  that  carries  the  amalgam 


152  CAST    GOLD   AND    PORCELAIN    INLAYS 

tooth,  and  the  opi)osiiig  tectli  are  secured  ])y  filling  the  ^vax 
impression  on  the  reverse  side  of  the  wax  l)ite  with  a  mix  of 
plaster  of  Paris.  Both  nj^per  and  lower  may  now  he  mounted 
upon  an  adjustable  crown  articulator. 

AVhen  the  plaster  has  set,  the  articulator  carrying  the 
models  and  bites  is  immersed  in  hot  water,  and  the  wax  bite 
is  removed,  disclosing  the  amalgam  tooth  in  the  correct  relative 
occlusal  position  to  the  opposing  teeth. 

All  of  these  opposing  teeth  are  now  thoroughly  varnished 
with  a  thin  solution  of  sandarac,  and  this  is  allowed  to  harden. 

AVe  are  now  ready  to  make  our  wax  inlay  for  the  cavity. 

A  cone  of  inlay  wax  of  suitable  size  is  made  ready  for  use 
by  softening  it  in  hot  water  in  the  manner  described  under  the 
heading  of  making  and  carving  the  wax  inlay  by  the  direct 
method. 

The  softened  cone  of  wax  is  forced,  as  also  previously  de- 
scribed, into  the  lubricated  cavity,  in  this  instance,  of  the  amal- 
gam die  instead  of  the  tooth. 

"While  the  wax  is  under  the  influence  of  the  finger  pressure, 
it  is  chilled  and  held  in  this  position  until  it  has  hardened,  then 
the  pressure  is  removed. 

All  we  are  concerned  with  at  this  stage  of  the  operation 
are  the  margins  and  seat  of  the  cavity,  and  the  approximation 
of  the  wax  to  this  seat  and  these  margins. 

"With  the  proper  carvers  and  flat  Inirnisliers,  right  and  left, 
all  but  the  occlusal  surface  of  the  wax  inlay  is  completed  at 
this  time. 

A  stream  of  cold  water  will  thoroughly  harden  the  wax  and 
a  jet  of  cold  air  will  dry  it.  A  ball  burnisher  is  now  heated  in 
the  Bunsen  flame  and  the  unfinished  occlusal  surface  is  sof- 
tened ceiitially:  that  is,  the  hot  insti'ument  is  allowed  to  enter 
the  wax  inlay  ai)out  half  way  down  into  the  body  of  it,  care 
being  exercised  not  to  a!h>w  the  heated  instrument  to  work 
Ihroiigh  the  wax  011I0  ilic  scat  of  ihc  caxiix',  or  up  to  the  mar- 
gins of  it. 

The  vai'iiished  and  raiutl}'  luhricated  opjj(xsi]ig  teeth  are 
now  allowed  to  descend  or  ascend  upon  the  wax  in  order  to 
designate  the  landmaik's  Coi-  occlusal  .'ai\iiig. 

A  close  stud\'  of  loolh  ana1oni\'  should  he  made  bv  ilie  in- 


TAKING    IMPIIKSSIOX    AND    MAKING    DIE  153 

lay  workci',  nn  illi  a  view  to  correct  reproduction  of  tooth  sur- 
faces in  ftonci-al  and  tlie  occlusal  surface  in  particular;  the 
sulci  and  dee])  iissures,  the  extreme  cusp,  elevation,  the  ini- 
])ortant  niarf-inal  i-id<;cs  functionino-  in  their  capacity  as  guard- 
ians of  the  interdental  tissues,  all  these  must  he  carefully 
rcpro<luced  in  outline,  hut  iiot  in  hulk;  in  other  words,  the 
important  thiii<;-  to  l)rin,<;'  about  is  an  exact  reproduction  of  the 
part  ol'  the  tooth  wliich  is  hicldn.i;'  to  make  it  a  perfect  dental 
organ,  l)nt  the  ('omjjlcmciitcl  ])ortioii  in  wax  nmst  he  as  much 
gi'eater  in  all  surface  areas  as  the  amalgam  cavity  with  all  its 
surfaces,  seat,  margins  and  angles,  is  smaller  tlian  the  cavity 
in  the  tooth. 

This  variation  between  the  tooth  cavity  and  the  die  cavity 
in  size,  is  but  microscopic,  and  hardly  appreciable  to  the  eye, 
nevertheless,  it  is  sufficient  to  spell  failure  for  every  casting 
made  l)y  the  indirect  method  unless  this  means  is  taken  to  over- 
come the  defect. 

The  articulator  and  models  which  carry  the  inlay  are  put 
aside  until  the  patient  appears  for  the  next  sitting.  The  inlay 
is  removed  from  the  die,  mounted  on  the  cork  which  carries  a 
])ankers'  pin,  the  pin  being  inserted  where  the  sprue  wire  is  to 
be  subsequently  attached. 

The  wax  inlay  thus  mounted  is  then  sul)merged  in  a  water 
bath,  the  tenq^erature  of  the  water  being  about  120°  F.  After 
a  lapse  of  two  minutes  it  is  carefully  removed  from  the  pin  and 
placed  uj^on  a  glass  slab;  the  temporary  stopping  is  removed 
from  the  tooth;  the  cavity  is  flushed  with  warm  water;  and  the 
wax  inlay  is  put  into  the  cavity,  a  firm  and  ever  increasing  pres- 
sure being  exerted  in  the  following  directions: 

If  the  cavity  be  a  disto-occlusal  one,  in  an  upper  tooth,  the 
pressure  must  be  directed  upwards  and  forward. 

In  mesio-occlusal  cavities,  the  pressure  nmst  be  upward  and 
backward. 

In  the  upper  mesio-disto-occlusal  cavities,  the  pressure 
must  be  uj^ward,  but  the  points  against  which  the  pressure  is 
exerted  must  be  the  marginal  ridges  of  the  wax  inlay.  This 
can  be  accomplished  by  making  a  V-shaped  cushion  of  the  thumb 
and  index  finger,  or  the  thumb  and  middle  finger  of  the  right 
hand. 


15-i  CAST    GOLD    AND    PORCELATX    INLAYS 

If  the  cavity  is  a  disto-oci'lusal  one  in  a  lower  tooth,  tlie 
13ressure  exerted  upon  tlic  wax  inhiy  must  be  directed  down- 
ward and  forward.  \n  k)wer  niesio-ocehisal  cavities,  the  pres- 
sure nuist  be  tlownward  and  backward,  and  in  lower  inesio- 
disto-occlusal  cavities,  the  pressure  must  be  directed  downwartl, 
and  it  must  be  exercised  against  and  upon  the  marginal  ridges 
of  the  inlay. 

"When  tlie  wax  thus  slightly  warmed  has  been  placed  in  the 
cavity,  and  the  carefully  exerted  ever-increasing  force  is  applied, 
the  inlay  will  begin  to  yield  under  this  jDressure  and  seat  itself 
against  every  part  and  margin  of  this  cavity. 

Presently  the  wax  will  cease  yielding,  but  the  pressure  must 
Ijc  maintained,  and  a  stream  of  cold  water  is  directed  wpon  and 
around  it  to  thoroughly  harden  it. 

With  the  various  carvers  and  right  and  left  burnishers, 
all  margins  are  now  carefully  gone  over  and  the  occlusion  made 
jDcrfect. 

The  interdental  and  gingival  portions  of  the  wax  inlay  are 
carefully  l)urnislied  with  the  flat  right  and  left  blade  burnish- 
ers, the  contact  area  between  the  wax  inlay  and  the  next  tooth, 
if  any  be  i^resent,  is  carefully  looked  to,  and  the  wax  is  pol- 
ished Avith  a  pellet  of  cotton  sparingly  moistened  in  oil  of 
cajejiut. 

An  exjilorer  is  inserted  into  the  distal  part  of  the  inlay 
and  it  is  carefully  removed  from  the  cavity  and  the  mouth, 
])lac('d  upon  tlie  jjalni  of  the  operator's  left  hand,  so  that  the 
disto-proximal  or  mesio-proximal  portion  of  it  be  uppermost. 

The  spi'ue  wire  is  heated  in  the  flame  of  tlie  Bunsen  burner 
ov  alcohol  lamp,  and  inserted  beyond  the  dej^th  of  the  ring  upon 
it,  midway  l)etween  the  buccal  and  lingual  extremities  of  tlie 
inlay.  Once  tlie  sprue  wire  has  in  its  heated  condition  entered 
the  inlay,  a  gentle  stream  of  cold  water  is  played  upon  the 
extreme  end  of  tlie  sjn-ue  wire,  or  better,  upon  the  Angers  that 
]\<)\<\  it  until  tli<'  \vir(!  is  cold.  This  must,  of  course,  l)e  done  l)y 
tlie  assistant;  if  none  be  present,  the  patient's  help  may  be  en- 
listed for  the  ])urj)Ose  or  the  tweezers  may  be  used. 

A  soft  rul)l)('r  s))oiige  placed  at  the  bottom  of  a  glass  of 
water,  serves  to  ('ffici'-ntly  sui)j)()i-t  the  wax  inlay-carrying  sprue 
until  tlic  cotton  rolls  ai-c  a])])li(M|  on  cither  sid<'  ()f  the  ])atient's 


TAKING    I.MPIMCSSIOX    AND    MAKIXC    DIK  ]'h) 

loolli;  the  sali\;i  cjcN-toi'  is  placed  in  position  llic  cavity  thor- 
ou^'hly  dried  out  and  filled  up  with  teiii])orary  stopping;  the 
patient  is  dismissed.  When  we  aic  ready  to  embed  or  invest 
the  inlay  in  the  reriacloiy  eonipoimd,  it  is  removed  from  the 
watery  sponge  Ix'd,  hy  grasj)ing  the  sprue  wire  carefnlly  witli  a 
])air  of  tweezers.  'J'lie  wax  inhiy  is  dried  with  a  gentle  jet  of 
cold  air  and  the  sprue  wire,  plus  inlay,  is  mounted  npon  the 
crucible  former.  Such  jjits  or  grooves  as  may  seem  necessary 
to  the  operator  may  now  be  carved  upon  the  wax  with  a  small 
sharp  lance,  i-ememhering  that  it  is  easiei-  to  do  this  in  the  wax 
than  in  the  metallic  duplicate  of  it. 

It  may  as  well  be  said  here  as  anywhere,  that  not  much, 
if  any,  dependence  should  be  placed  upon  these  grooves  or  pits 
as  retaining  factors  between  an  inlay  cavity  and  an  inlay,  and 
l^ersonally  I  resort  rarely,  if  at  all,  to  this  practice,  for  reasons 
to  be  touched  ujion  later. 

Xow,  before  jDroceeding  to  the  next  step  in  the  construc- 
tion of  a  cast  gold  inlay,  may  I  be  i^ermitted  to  ask  the  advo- 
cates of  the  indirect  method,  to  again  read  what  has  been  said 
in  regard  to  directions  for  taking  the  impression,  making  the 
die,  and  carving  the  wax  inlay  by  means  of  this  method.  In 
full  justice  to  the  i:)atient,  to  the  art,  and  to  themselves,  let  tliein 
read  and  let  them  construct  an  inlay  as  they  read,  and  let  them 
imj)licitly  follow  directions,  and  then  let  tliem  construct  an 
inlay  in  accordance  witli  their  nsual  procedure;  let  them  then 
compare  both  results  by  p)utting  the  tinislied  products  into  the 
tooth  cavity. 

In  the  tirst  instance  they  will  have  a  complemental  product 
which  will  interplay  with  all  the  cavo-snrfaces  of  the  tooth  with 
a  grateful,  frictional,  and  supporting  contact,  and  as  to  what 
they  will  find  in  the  second  one,  I  am  ready  enough  to  leave  to 
their  judgment,  providing  they  liave  examined  the  first.  Up 
to  the  present  time  I  have  found  no  other  means  of  making  an 
accurate  inlay  l)y  the  indirect  method,  except  the  one  minutely 
described,  and  when  the  advocates  of  the  so-called  indirect 
method  shall  have  read  and  followed  these  directions,  they  will 
admit  readily  enough  that  the  method,  if  carried  out  as  to  each 
detail,  will  bring  desirable  results,  but  they  will  also  add  that 
the  time  sjDent  in  obtaining  the  results  is  far  too  great. 


156  CAST   GOLD   AND   PORCELAIN    INLAYS 

Surely,  if  tliey  are  seeking-  better  results  by  means  of  an 
indirect  method,  and  if  their  indirect  method  is  not  quite  ef- 
ficient, and  if  all  these  steps  I  have  described  and  all  these 
directions  I  have  given  do  lead  to  a.  more  perfect  result,  that 
is  the  indirect  method  which  they  should  adopt. 

On  the  other  hand,  there  is  nothing  which  they  can  ac- 
complish, no  result  which  they  will  j^roduce,  by  following  every 
detail  of  those  directions  most  studiously  and  indulging  in  the 
expenditure  of  all  the  time  necessary,  which  may  not  be  dujDli- 
cated  i^erfectly  in  every  detail,  in  a  great  deal  shorter  period  of 
time,  if  they  follow  the  directions  given  for  the  construction  of 
the  wax  inlay,  in  accordance  Avith  the  rules  originally  laid  down 
l)y  him  wliom  they  all  call  great,  Avho  is  responsible  for  the 
very  existence  of  the  cast  gold  inlay;  in  other  Avords,  if  they 
folloAv  the  direct  method. 

The  cast  gold  inlay  made  by  the  indirect  method,  Avhicli  is 
here  described  in  detail,  compares  A^ery  faA^orably  Avith  those 
made  1)y  the  direct  method;  in  fact,  it  is  impossible  to  differ- 
entiate them  at  all. 

Tt  must  be  remembered  that  here  the  indirect  method  Avas 
used  only  as  an  accessory  to  the  direct,  and  that  the  time  con- 
sumed Avas  far  greater  than  if  the  direct  method  alone  had  been 
emploA^ed.  Also,  no  time  had  been  saA^ed  to  the  patient;  in  fact, 
another  Adsit  Avas  the  result. 

We  are  forced  to  the  conclusion  that  the  direct  method  is 
the  rational  one,  and  that  they  avIio  desire  to  foUoAv  a  correct 
indirect  method,  aiid  avIio  Avish  to  eliminate  guess  Avork,  must 
gi\('  lliat  wliicli  all  indirect  methods  of  doing  anything  entail, 
namely,  thej"  nuist  giA'e  up  more  time. 

The  one  advantage  the  indirect  method  may  claim  is  that 
it  Avould  be  possible  to  break  up  one  protracted  sitting  of  a 
patient  into  two  shorter  sittings. 

Tn  feeble,  convalescent,  or  exceedingly  nervous  individ- 
uals, tliis  7nethod  Avoi'ks  to  better  advantage,  and  those  are  the 
conditions  it  Avas  perfected  for  and  is  used  in,  l)ut  it  cost  more 
time  and  dTort  to  produce  an  acceptable  result  in  lliis  \va>',  llian 
it  would  lo  olilain  1lu'  same  i-csult  willi  llic  dii-<'('1   method. 


TAK1X(;    IMlMtKSSIOX    AND    .MAKIXi;    DIE  157 

SUMMAKY   FOR   CHAPTER   IX 

Taking  an  Impression  of  the  Cavity  and  Making   a  Die  for  Procedure  by  the 

Indirect  Method 

1-    (iivc    tlic    reasons    why    in    the    writer's    opinion    tins    metiifxl    is    unscientific. 

2.  When  may  it  be  used  in  conjunction  with  the  direct  method? 

3.  Describe   the   trays   devised   for   use    with    the    indirect    nicthod    and    the 
tochnic  of  tlieir  applicatifjn. 

The  Making  of  the  Amalgam  Die 

1.  Why  is  a  copjx'r  alloy  preferable? 

2.  Describe   the   method   of  x'''^'I):^i"i'ig  the   copper   alloy   for   the   packing   of 
the  compound. 

3.  Describe  the  method  of  making  the  wax  pattern  from  the  metal  die. 

4.  Describe  the  technie  of  transferring  the  wax  pattern  from  the  die  to  the 
cavity  and  the  conformation  of  the  pattern  to  the  tooth. 

5.  Describe  the  detail  of  inserting  the  sprue  wire  into  the  wax  pattern  and 
its   disposal   before   investing. 


CHAPTER  X 
THE  INVESTMENT,  OR  REFRACTORY,  COMPOUND 

As  tlie  lieadino-  of  tlie  chapter  implies,  the  investment  is 
tlie  mass  into  which  the  wax  inlay  is  emhedded,  to  form  a  mohl 
into  wliich,  npon  vohitilization  of  tlie  Avax,  the  inetal  may  ho 
forced  to  assume  a  detinite  shajDe. 

Because  the  metal  must  he  forced  into  this  mold  in  a  lici- 
uefied  condition,  and  hecause  it  requires  a  great  deal  of  heat  in 
order  to  liquefy  the  metals  used  for  inlays,  the  compounds  or 
suhstances  that  make  uj)  the  investment  must  he  refractory, 
that  is,  they  must  in  themselves  and  in  comhination  with  each 
other  joossess  the  iDrojDerty  of  resisting  disintegration  under  heat 
of  considerahle  degree. 

"While  this  is  an  important  property  of  the  compound,  it 
is  no  more  so  than  the  projierties  enumerated  helow,  and  unless 
a  compound  can  meet  the  requirements  stated,  it  is  unfit  to  he 
used  for  the  making  of  molds  into  Avliich  inlays  are  to  he  cast. 

Since  these  castings  are  to  he  made  under  pressure  of  one 
kind  or  another,  the  comj^ouiid  used  should  he  strong  enough  to 
resist  such  pressure;  and  since  such  pressure  varies,  the  com- 
pound should  possess  a  safety  margin  of  pressure  resistance  at 
least  doul)le  that  of  the  amount  required. 

JJecause  oi'  accui'acy  j-equired  in  the  rein'oductiou  of  line 
lines,  angles  and  margins,  the  compound  must  he  one  that  Avill 
crystallize  in  sucli  iniiiute  crystal  f'oi-inaliou  as  will  enahle  these 
crystals  to  moxc  into  every  line  and  dejnx'ssion  of  the  pattern. 

At  the  same  time  the  crystals  must  be  of  such  shajjc  that 
Ihc  hardened  or  set  mass  will  present  a  structure  sufficiently 
])Oi'ons  to  caiwy  off  any  gases  foi'ined  in  the  ]ii()l(l  dnring  ihc 
])rocess  of  vohililizalion,  and  dnring  1iii'  process  of  Ihc  inlrcxhic- 
tion  of  the  metal. 

Smoothness  of  1iic  mass  nmsl  also  he  (M)iisi(h're(l,  and  sinc(^ 
that    is   a    (|nali1y    lliat    is    nsnaily    ohlnincd    at    the    expense    of 

]5S 


J.WKSTMHX'I',    OK    JtKIKAC'I'OltV,    ( 'O.M  l*(  )r  X  I)  159 

j)()r()sity,  it  iji'csi'iitt'd  at  lirsl  an  almost  iiisiii'iiiouiilaljlc  ohslaclo 
ill  tlie  chain  of  steps  essential  to  success  in  the  art. 

Finally,  the  Avorkin^'  (jnalities  of  the  mass,  M'hen  mixed  for 
use,  must  be  such  as  to  <;ive  the  user  a  sufficient  amount  of  time 
to  carefully  invest  his  ])attern,  wliicli  means  that  when  properly 
mixed,  the  mass  x)reseiits  the  appearance  of  a  cream,  smooth  and 
easy  (lowin<;',  and  free  from  air  cells. 

A  ^reat  many  of  the  refractory  agents  su^'^ested  themselves 
to  the  investigators,  many  of  whom  are  even  now  engaged  in 
the  j)robleni  of  trying  to  compound  a  more  perfect  investment 
material. 

All  of  them  have  been  compelled  to  retain  as  a  portion  of 
the  mass,  a  considerable  quantity  of  plaster  of  Paris  as  a  bind- 
ing force  for  the  wdiole. 

Plaster  of  Paris  is  manufactured  from  the  mineral  called 
gyj3sum,  which  is  comparatively  soft. 

Chemically,  it  is  a  hydrated  sulphate  of  lime,  CaSOi  +  2H2O. 
Its  specific  gravity  is  2.31  and  its  hardness  is  from  1.5-2  of  the 
mineral  scale. 

The  three  most  frequent  varieties  of  it  are  known  as  ala- 
baster, a  marble-like  mass  usually  faintly  tinted  and  translu- 
cent; a  selenate,  which  is  crystallized  and  transparent;  and  a 
variety  known  as  satin  sj^ar,  which  has  a  pearly  opalescence 
due  i^erhaps  to  its  fibrous  foundation. 

Gypsum  has  a  wide  geologic  distribution,  the  extensive  beds 
of  the  common  variety  generally  occurring  as  irregular  concre- 
tions in  nodular  masses,  and  it  is  frequently  found  associated 
with  rock  salt.  A  mineral  known  as  anhydrite  or  anhydrous 
sulphate  of  lime,  found  near  the  Harz  Mountains  and  in  i:)arts 
of  Xova  Scotia,  may  be  converted  into  gypsum  by  the  addition 
of  water. 

(lypsum  contains  21  per  cent  of  water,  which  can  l)e  driven 
off  by  heat,  it  is  burned  in  kilns  at  a  temperature  of  250°  F., 
then  ground  to  a  fine  powder,  ainl  as  such,  it  is  known  as  plaster 
of  Paris.  This  recombines  with  water,  evolves  heat,  and  crys- 
tallizes at  the  expiration  of  a  few  minutes. 

If,  in  the  burning  of  the  gypsum,  the  temperature  be  raised 
to  or  about  480"  F.,  and  then  ground  into  a  fine  powder,  it  will 
be  found  to  have  lost   its  power  of  dehydration  and  in  this 


160  CAST    GOLD    AND    POliCELAlN    INLAYS 

state,  it  will  not  set  Avlien  mixed  with  water  and  it  is  said  to  be 
dead  burnt. 

At  ordinary  temperature,  gypsum  and  jjb^ster  of  Paris  are 
soluble  in  water,  in  the  proportion  of  two  and  a  fraction  of 
the  solids  to  1000  parts  of  water,  and  its  jDoint  of  maxinmm  solu- 
bility is  about  95°  F. 

Plaster  of  Paris  shrinks  upon  being  heated,  and  in  itself 
is  therefore  an  unreliable  mass  for  molds  which  are  to  receive 
high  fusing  metals,  or  allo^^s  in  a  liquefied  state. 

Some ,  of  the  other  materials  used  as  refractories  are  the 
compounds  of  silica,  alumina,  magnesia,  and  calcium. 

Of  these  the  silica  is  the  most  important,  for  although 
utterly  lacking  in  tensile  strength,  it  has  the  property  of  ex- 
i:)anding  when  heated.  * 

SILICON 

Silicon  is  one  of  the  nonmetallic  elements:  symbol  Si; 
atomic  weight  28.3(0-16);  sp.  gr,  of  crystalline  form,  2.49.  It 
may  be  obtained  in  two  different  forms :  viz.,  the  amorphous 
and  the  crystalline. 

Amorphous  silicon  presents  the  apj^earance  of  a  dull  brown 
powder,  prepared  by  heating  silicon  with  aluminum.  It  is 
nonconductor  of  electricity,  and  when  heated  in  air  or  oxygen, 
its  external  surface  burns  brilliantly,  and  is  converted  into 
silica,  which  fuses  from  the  extreme  heat  and  forms  a  coating- 
over  the  unburned  silicon.  Deville  obtained  crystallized  silicon 
in  regular  six-sided  pyramids  of  a  dark  steel-gray  color.  A 
somewhat  impure  form  is  prepared  by  the  Carborundum  Com- 
pany of  Niagara  Falls  by  heating  coke  and  sand  in  an  electric 
furnace. 

Silica,  or  silicon  dioxide,  exists  both  in  the  crystalline  and 
in  tlie  amorijhous  form.  The  best  examples  of  the  crystalline 
form  are  rock  crystal,  quartz,  chalcedony,  flint,  sandstone  and 
quartzose  sand.  Silicon  in  this  form  has  a  specific  gravity  of 
about  2.9,  and  is  only  attacked  with  difficulty  by  potash  or 
hydrofluoric  acid.  The  amorphous  form  exists  naturally  in  opal, 
and  is  obtained  arlificially  as  gelatinous  silica,  etc.  It  differs 
fi'oin  Ihc  foi-inoi-  in  its  specific  gravity,  being  about  2.2,  and  in 


ixvEST.MKX'i",  oi;   i;Kri;A("r()i;\',  com  rorxD 


161 


its  bc'iii^'  raj)i(lly  dissolvt'd  by  jjotasli  and  l)V  liydrolluoric  acid. 

Pure  sillcd  (ds  it  occurs  In  rock  crusted,  for  eXrample)  is 
perfectly  f rdiisjxnoti  (Uid  colorless,  mid  is  sufjicicntly  liard  to 
scrcdcli  f/ldss.  The  heal  of  the  o.ii/li i/d rof/cn  Idowpipc  is  re- 
quired for  its  fusion,  ulicu  il  uiclls  into  a  I runsparcuf  f/lass, 
cupdhlc  of  hciufi  (IrdU)i  out  i)do  electric  th redds.  SiTH-ic  acid 
may  be  precipitated  by  addition  of  hydi'ocldoric  acid  to  a  so- 
lution of  sodium  silicate.  l>y  exposing  the  silicic  acid  to  red 
heat,  pure  amor])lious  silica  may  be  obtained.  The  solubility 
of  hydrattnl  silicic  acid  in  water  accounts  for  the  presence  of 
silicic  acid  in  mineral  springs,  and  in  the  geysers  of  Iceland, 
as  well  as  for  its  gradual  separation  from  those  Avaters  in  the 
form  of  petrifactions.  Silicates  are  salts  of  silicic  acid  (of 
which  several  hydrated  forms  have  been  obtained)  or  combina- 
tions of  silicon  dioxide  and  metallic  basic  oxides.  They  may 
be  divided  into  five  classes:  (1)  Orthosilicates,  derived  from 
HiSiOii  (2)  Metasilicates,  from  HoSiOs;  (3)  Disilicates,  from 
HoSioOr, ;  (4)  Trisilicates,  from  HoSivO,. ;  and  (5)  Basic  silicates. 
They  occur  abundantly  in  nature,  all  the  forms  of  clay,  felspar, 
mica,  hornblende ,  augite,  serpentine,  etc.,  being  compounds  of 
this  description.  Most  of  the  silicates  are  fusible,  the  basic 
silicates  fusing  more  rapidly  than  those  of  wliicli  are  either  neu- 
tral or  contain  an  excess  of  acid.  Excepting  the  silicates  of  the 
alkalies,  there  are  no  silicates  which  are  soluble  in  water. 

Silicon  is  largely  employed  in  the  manufacture  of  glass, 
chiiia  and  porcelain.  The  use  of  silica  in  giving  firmness  and 
rigidity  to  various  parts  of  the  animal  organs  is  exemplified  in 
its  free  occurrence  in  the  quill  part  of  the  feather  of  birds,  in 
the  shields  of  certain  infusoria,  and  in  the  spicula  occurring  in 
sponges,  while  its  similar  use  in  the  vegetable  kingdom  is  seen 
in  its  more  or  less  abundant  presence  in  the  stalks  of  the  grasses, 
more  particularly  in  the  cerecds  and  in  the  bamboo. 

Silicon  combines  with  several  other  elements  besides  oxy- 
gen, the  most  important  comjDonnds  being  silicofluoric  acid 
(HaSiFi)  and  silicon  carbide,  or  carborundum  (SiC),  Avhicli  is 
very  hard  and  used  for  grinding  and  polishing.  Silicon  fluoride 
(SiFi)  is  a  colorless  gas  usu-ally  prepared  l)y  heating  together 
calcium  fluoride  and  strong  sulphuric  acid.  It  is  decomposed 
into  water  silicic  acid,  and  silicoflnoric  acid. 


IGll  CAST    (JOIJ)    AND    roilC'ELAlX    INLAYS 

CALCIUM 

Calcium  (synil)ol  Ca;  atomic  w(  i,i;lit  -lO.OD)  is  the  metal 
I^resent  in  chalk,  and  other  compounds  of  lime.  It  may  he 
obtained  by  passing  a  current  of  electricity  through  fused  chlo- 
ride of  calcium.  It  is  a  yellowish  white  metal,  intermediate  he- 
tiveen  lead  and  (/old  'ni  hardness.  At  ordinary  temperatures, 
it  rapidly  decomposes  in  water,  forming  lime,  CaC,  ichile  hy- 
drogen eseapes.  It  forms  an  oxide,  lime,  having  the  composi- 
tion of  forty  parts  of  calcium  and  sixteen  parts  of  oxygen. 
Sulphate  of  calcium,  CaSOi,  is  the  chief  constituent  of  gypsum. 
It  is  present  in  most  drinking  waters,  rendering  them  perma- 
nently hard.  Temporary  hardness,  due  to  the  presence  of  car- 
bonate of  calcium  or  chalk,  is  removable  by  boiling. 

MAGNESIUM 

Magnesium  (symbol  }ilg;  atomic  Aveight  24.32)  is  a  metal 
which  is  very  widely  distributed  over  the  globe.  It  is  present 
in  magnesite,  magnesium  carbonate,  dolomite,  carbonate  of  lime 
and  magnesia,  asbestos,  silicate  of  lime  and  magnesia,  meer- 
schaum-silicate of  magnesia,  kainite,  and  in  other  minerals.  It 
exists  in  mineral  waters  and  the  sea  as  sulphate  and  chloride, 
the  sulphate  being  known  as  epsom  salts.  The  metal  is  made  by 
fusing  together  the  chlorides  of  potassium  and  magnesium  and 
IJuor  spar,  and  adding  metallic  sodium  with  great  care.  The 
crude  metal  is  finally  distilled  and  pressed  in  a  semifluid  state 
into  ribl)on  or  wire. 

Magnesium  has  a  silver  white  color,  which  is  tarnished  by 
moist  air.  It  is  a  very  light  metal,  its  specific  gravity  being 
oiil>'  1.75.  It  is  readily  volatiU-,  and,  when  lighted,  burns  in 
air  with  an  intensely  brilliant  light,  rich  in  chemical  rays.  On 
tills  account  it  was,  until  superseded  by  the  electric  light,  nmch 
used  ill  pliologi-a])li\',  while  in  signaling  and  pyrotechny  it  plays 
an  important  jjart. 

When  magnesium  l)urns  in  aii-,  it  forms  a  white  ash  con- 
sisting of  the  oxide,  nuignesia,  ]\lg()  (whicii  may  also  be  pre- 
pared by  heating  the  carbonate).  The  caihonate,  MgCO^,  is 
found  in  nature,  but  for  medical   pui-poses  it  is  prepared  by 


JXVEST.MKXT,    OI!    r.KI'KAC  "^()l;^■,    COM  I'OI'XI)  !().') 

precipitating-  a  soluble  iiia.uiK  siiiiii  salt  with  carhoiiate  of  soda. 
Although  iiisolul)le  in  water,  this  substance  readily  dis- 
solves in  water  containing  carl)onic  acid,  and  this  solution  is 
known  as  fhiid  magnesia.  The  sul|)hate,  MgSO,  •  7H.0,  or  ep- 
som  salts  (an  infusion  ot  whicli  with  senna  is  known  as  l)lack 
draught),  occurs  in  nature,  and  is  well  known  as  a  domestic 
remedy.  Citrate  of  magnesia  is  the  popuhir  name  for  a  granu- 
lar, effervescing  aperient.  It  consists  of  a  mixture  of  bicar- 
l)onate  of  soda,  tai'taric  and  citi-ic  acids,  sngai',  and  a  small  trace 
of  e])som  salts. 

ALUMINA 

Alumina  is  the  most  abundant  of  the  earths;  it  is  the  oxide 
of  metal  aluminum,  the  formula  l)eing  AUO..  It  occurs  in  na- 
ture abundantly  in  combination  with  silica,  associated  with 
other  l)ases.  The  most  familiar  of  its  native  compounds  is 
felspar,  a  silicate  of  alumina  and  potash,  K^O,  ALO:^,  GSiO.. 
Certain  varieties  of  this,  by  exposure  to  the  atmosphere,  l)e- 
come  completely  distintegrated;  passing  from  the  state  of  hard, 
solid  rock,  such  as  we  are  accustomed  to  see  in  building  granite, 
into  soft  crumbling  earthy  masses.  Clay  consists  of  a  silica  and 
alioniiia  in  a  state  of  cJiemical  comhiuation.  It  never  is  pure 
alumina,  hut  the  cjuantitij  of  silica  united  to  the  latter  is  vari- 
able. Wlunt  it  is  pure,  claii  is  quite  white,  but  more  frequently 
clay  is  red,  owiiu/  to  the  jjresence  of  oxide  of  iron;  or  black, 
from  the  diffusion  throuyh  it  of  vegetable  matter. 

From  alum,  alumina  is  prepared  by  adding  to  a  solution 
of  the  former,  water  of  annnonia,  as  long  as  it  occasions  a  pre- 
cipitate. AVlien  alumina  is  precipitated  from  a  solution  con- 
taining coloring  matter,  such  as  logwood,  etc.,  it  carries  down 
the  color  chemically  united  to  the  Hocculent  jn'ecipitate;  in  this 
way  are  formed  the  colored  earths  called  lakes.  Alumina  in 
the  state  of  the  precipitate,  after  l)eing  gently  dried,  is  readily 
soluble  in  acids  and  in  alkalies;  but  if  strongly  heated  at  a  cer- 
tain temj^erature,  it  j^resents  an  appearance  of  sudden  incan- 
descence; it  loses  the  associated  water,  contracts  f/reatli/  in 
hulJx,,  and  now  forms  a  white  soft  powder,  not  at  all  r/ritti/,  and 
Avith  difficulty  soluble  in  all'alies  and  acids.  Alumina,  as  gen- 
erally prei3ared,  whether  hydrated  or  anhydrous,  is  soluble  in 


1G4  CAST    t;OLD    AXl)    POl'vCELAIX    IXLAYS 

water,  j)OSsesses  no  taste,  and  docs  not  alter  eolorin,!;-  niatters, 
l)ut  it  has  also  been  obtained  in  an  allot ropic  liydrated  form, 
Avliieli,  in  the  presence  of  a  very  small  x)roportion  of  acetic  acid, 
is  largely  soluble  in  Avater,  from  which  a  minute  trace  of  sul- 
furic acid  j)recipitates  it.  In  the  anhydrous  state  it  absorbs 
water  with  great  readiness  Avitliout  combining  with  it,  so  that 
it  adheres  to  the  tongue,  and  if  left  parches  it.  Claij  retains 
this  property;  the  ends  of  tobacco  pii:>es  are  often  glazed  to 
prevent  adliesion  to  the  lips  or  tongue.  Alumina  is  not  fusible 
by  a  forge  or  furnace  heat,  but  it  melts  before  the  oxijhydrogen 
blowpipe  into  a  clear  globule,  i:)0ssessing  great  hardness.  The 
more  coarsely  crystallized  specimens  form  the  emery  which  is 
used  for  polishing;  the  transparent  crystals  when  of  a  bhie 
color,  owing  to  a  trace  of  metallic  oxide,  constitute  the  precious 
gem,  the  sapphire;  and  when  red,  the  ruljy.  Alumina,  in  com- 
mon with  other  sesquioxides,  is  a  feeble  base. 

Like  alumina,  magnesium  and  calcium  are  unreliable  as  to 
constancy  of  bulk  upon  accession  of  heat,  and  so  were,  in  and 
by  themselves,  not  to  be  favored  as  constituents  of  any  mass 
to  be  used  for  molds  into  wliich  too  high-fusing  metals  were  to 
be  cast. 

The  apparent  impossibility  of  obtaining  all  these  refrac- 
tories in  a  pure  state  was  another  trying  joroblem  which  had  to 
be  solved  before  a  really  worthy  compound  could  be  produced. 

It  may  be  safely  asserted  that  all  the  investment  com- 
pounds at  present  offered  to  the  profession,  contain  one  or 
more  of  the  refractories  enumerated,  in  a  varying  combination 
with  jjlaster  of  Paris;  some  are  carefully  determined  coi-rect 
relative  combinations;  some  are  haphazaidlx'  tliiown  togetliei-, 
mixtures  of  ({uestionablc  A'aluc,  the  sale  of  wliicli  should  he  ])i-()- 
hibitcnl. 

So  ]iiucli  of  the  success  in  casting  dej)ends  upon  a  deix  iid- 
al)le  mold  that  only  the  very  best  at  loresent  to  ))e  o))taine(l 
should  bi'  fo]isidered. 

For  a  long  time  I  used  a  compound  which  T  mixed  foi-  my- 
self in  accoi'dance  with  the  following  formula: 

Plaster  of  Paris    "/>  t 

Rilox    ijIm 

Graphite    flakc-s    (small;     vl'i— -)-iJ— 1- 


INVESTMENT,    Oil    ItKFIIAC  TOlt V,    COMPOUND  1(35 

Tlic  process  of  Jiial<iii,i;'  this  conipouiKl  was  aliciidcd  with 
so  iiiucli  iiicouvenieiico  and  llic  lesults  (because  of  the  unrelia- 
bility of  tlie  products)  M'ore  so  iuconslaut,  that  the  vai'ious  coiu- 
])ounds  on  the  market  Avere  caicfuily  tried  out,  and  the  Tag-- 
<;'art  investment   fuially  (h'ci(le(l  upon. 

Such  ftreat  care  is  used  in  the  nianufactui-e  of  tliis  invest- 
ment that  takin*;-  the  variation  in  teini)erature  into  considera- 
tion and  allowing-  for  these  thermal  changes,  constant  results 
may  invariably  be  attained. 

1  have  been  unable  to  detinitely  ascertain  just  what  the 
jiroportion  of  the  vai'ious  ingredieids  which  enter  into  the  mak- 
ing of  this  compound  are,  ])ut  the  product  has,  after  a  period 
of  three  years,  proved  so  satisfactory  and  so  thoroughly  reli- 
able in  its  working  qualities,  that  I  unhesitatingly  give  it  first 
j)lace  in  the  list  of  those  at  preseid  urged  u])on  the  profession. 

Some  conunon  sense  precautions  must  be  taken  in  using  this 
refractory  comiDOund,  which,  in  order  to  ))e  emjdoyed  for  molds, 
must  he  mixed  with  water. 

The  powder  nuist  he  kei)t  in  a  (dosed  receptacle  in  a  dry 
place,  not  exposed  to  rajnd  changes  of  temperature;  it  nmst  l)e 
mixed  with  water  neither  too  cold  nor  too  warm. 

Water  at  room  temperature,  ahout  7.")"  F.,  will  do  well 
during  the  cold  weather.  TIds  may  he  had  by  allowing  a 
pitclierful  of  the  water  drawn  from  the  faucet,  to  stand  in  the 
room  all  day,  thus  modifying  its  temj^erature  with  that  of  the 
room.  During  the  hot  months,  cold  water  may  he  added  to  that 
ohtained  from  the  faucet  and  the  desired  results  reached  in 
this  way. 

It  nmst  he  remembered  that  all  these  investments  are  hy- 
groscopic ;  they  have  a  great  affinity  for  moisture,  and  the  cans 
must,  therefore,  be  kept  tiglitly  closed.  For  the  same  reason  it 
will  require  less  water  for  a  xierfect  nux  during  very  humid 
weather  than  dui'ing  dry  weather. 

The  quota  of  investment  i^owder  and  water  having  l)een 
made  constant  by  Taggart,  the  variation  of  temperature  and 
humidity  may  he  taken  care  of  l)y  the  addition  of  a  few  min- 
ims of  water  during  excessively  dry  weather,  and  by  the 
reduction  of  the  quantity  of  water  in  the  same  proportion  dur- 
ing the  extremely  liunud  weather.     In  no  case  is  amount  of 


l(i(j  CAST    GOLD    AND    POItt'EJ.AIX    INLAYS 

variation  .greater  Uiaii  20  drops,  ruiniing  from  that  down  to  5. 

The  small  qnantity  of  graphite  flakes  used  in  the  investment 
enables  us  to  ol)tain  a  smooth  mass  without  the  loss  of  too  nuich 
porosity  of  the  mold. 

The  things  absolutely  necessary  for  a  proper  mix  of  invest- 
ment are  these: 

The  investment,  powder  and  water,  a  small  scale  in  which 
the  quantity  of  each  may  be  detinitely  determined,  subject  to 
variation  with  atmospheric  changes,  a  large  rubber  cup  kept 
scrupulously  clean,  and  used  for  this  purpose  only,  and  a  broad, 
flexible,  hard  rubber  spatula. 

The  large  cup  in  the  scale  is  used  as  a  scoojo  and  loosely 
filled  with  the  powder;  the  surplus  is  removed  by  passing  the 
sharp  edge  of  the  spatula  across  its  circumference. 

The  scale  is  now  placed  upon  the  fulcrum  and  enough  water 
is  jjoured  into  the  small  cup  to  balance  the  weight.  This  is  best 
accomjjlished  by  using  a  rubber  bulb  water  syringe  of  average 
size.  If  the  humidity  in  the  air  be  noticeable  to  a  considerable 
degree,  an  even  balance  will  be  the  correct  amount  of  water  re- 
quired. If  the  atmosphere  be  normal,  a  balance  so  that  the 
small  cup  will  descend  to  rest  upon  the  table  will  be  found  nec- 
essary, and  this  will  require  an  additional  5  drops  of  the  fluid. 
If  the  atmosphere  be  excessively  dry,  the  scale  should  be  evenly 
balanced  and  20  drops  of  water  added  to  this. 

The  i)laster  in  the  powder  requires  its  21  per  cent  of  mois- 
ture to  be  thoroughly  satisfied.  It  contains  this  much  in  its 
natural  state  en  masse,  and  it  will  not  ])e  as  good  a  binder  for 
this  new  mass  unless  suj^plied  with  the  proj^er  quota  of  moisture. 

The  I'ubber  bowl  made  clean  and  dry,  now  receives  the 
water  from  \\w  small  end  of  the  scale;  it  is  best  to  place  the 
cover  of  tlic  can  or  a  piece  of  stiff  cardboard  over  that  part  of 
the  scale  wliir-li  coulaiiis  tlic  ])0\v(l('r,  and  holding  this  cover 
down  u])on  the  mass,  the  scale  is  inverted  over  the  bowl,  and 
the  water  jjoured  into  the  new  receptacle. 

The  scale  is  now  gi-asped  in  the  oljici-  liand,  the  cover  is 
fenio\('(l,  ;iii(|  Ihe  jtowder  cai-cruIlN'  liii'owii  into  the  howl. 

I'sing  the  spatula,  the  ])ow(iei'  is  made  to  lake  up  the  inois- 
lui'(j  hy  agitating  the  mass;  when  that  seems  accomj)lislied,  a 
minute  should  eiai)se  before  the  mix  is  again  touched,  as  that 


XVKST.MKXT,    OK    i;KFi;A('T()in',    COM  POT  XD 


1(17 


will   -ivc  liic   i)last('r   tiiiic  ciiou^li   to   cxliaiist    its  ^-as  ]iiakiii<^' 
tendencies. 

After  tlie  miiiutc  of  I'est,  tlie  rul)l)er  ])o\vl  is  seated  in  tlie 
palm  of  tlie  left  liaiid  and  tlie  ri^lit  hand  li()ldin<;-  the  spatnla, 
hi-oad  si(h'  i)arallel  with  front  of  the  hody,  is  now  agitated  eir- 
('iiiiifereiiliall\    iinlil  tlic  pow(k'r  seems  to  have  taken  n])  all  of 

the  water. 

The  mass  is  then  spread  over  llie  entire  innei-  surface  of 
tlie  cnp,  ill  a  thin  liomo^i-eiieous  layei".  The  si)atula  is  dispensed 
with  and  the  cup  is  taken  uj)  in  the  right  hand,  llattened  some- 
what hy  gentle  pressure  of  the  fingers,  and  gently  hammered 
against  the  edge  of  the  tahle  or  heneh,  and  rotated  after  each 
concussion,  always  rememhering  to  keep  the  mass  spread  out 
as  a  thin  layer  over  the  inner  surface  of  the  bowl. 

If  the  mass  is  handled  in  the  manner  described,  any  en- 
closed air  l)ul)l)les  will  be  brought  to  the  surface  and  the  contin- 
uous concussion  and  rotation  of  tlie  ])owl  will  cause  their  col- 
lapse. 

The  flakes  of  graphite  will  aid  in  the  gliding  by  of  o])struc- 
tive  ])articles  which  might  otherwise  tend  to  imprison  objec- 
tionahle  (piantities  of  air. 

The  time  spent  in  mixing  the  compound  should  amount  to 
fully  three  minutes,  including  the  one  minute  given  to  the  ex- 
haustion of  the  plaster  in  its  gas  producing  tendency,  unless  an 
automatic  mixer  is  used,  in  which  case,  fully  five  minutes  must 
be  given  to  the  mixing  process  in  order  to  obtain  satisfactory 

results. 

The  ([uantity  of  water  must  l)e  increased  while  using  the 
automatic  mixer,  and  that  may  be  definitely  done  l)y  obtaining 
a  small  steel  ball  •;!.;  inch  in  diameter,  and  dropping  it  into  the 
little  depression  ])rovided  near  the  larger  cup  in  the  scale. 

I  have  been  able  to  obtain  nuich  better  results  l)y  using  the 
mixer,  and  I  have  been  able  to  more  definitely  duplicate  my 
results  by  eliminating  the  varying  human  element  in  the  process 
of  mixing. 

The  maniKU-  of  ])rocedure  is  as  follows: 

The  ])roi)ortioiis  of  water  and  ])owder  are  measured  off  as 
outlined,  and  put  into  the  cup  of  the  mixing  apparatus;  the 
cover  is  placed  tightly  upon  the  cup,  and  the  mass  is  well  shaken 


168 


CAST    GOLD    AXD    POKCET.ATX    IXLAYS 


Fio-.  163. — The  Tago-avt  niitoinatio  iiivcstiiioiit  mixor  attached  to  a  lathe. 


Fig.  104. — The  Taggart   .■uiloin.'it  ic   iii\  csl  mmt    mixer  :it  I  jk-ImmI    In   its   (jwii   iiuitur,  a 
clock   witli    an   ahinii    wliicli    liiig.s    wlicn    tln'    roiii|i(iiiiii|    is    icaily    I'lir    u?^c. 


ixyp:.si\mi<:xt,  on  refe actor v,  compound  KJ!) 

11])  I'oi-  a  iiiiimtc,  till'  tube  ('xtciidiii*;-  ol)li(|U(']y  or  acutely,  as  tlie 
case  may  l)e,  from  the  cover  of  tlie  cup,  and  is  tlien  slipped 
over  the  spindle  Avliicli  extends  from  the  apparatus.  Tliis  spin- 
dle projects  anteriorly  and  at  rift-ht  angles  from  the  little  ^ear 
box  Avliicli  is  su])porte(l  on  a  stand,  and  slipped  tightly  over  the 
shaft  of  the  lathe. 

On  the  u])i)er  i)art  of  the  j<;('ar  hox  is  another  })ro,jection 
into  which  a  small  alarm  clock  of  special  construction  is 
fastened. 

The  tuhe  which  extends  ol)li(iuely  fi-om  the  cover  contains 
a  horizontal  cut  about  %  inch  down  its  length,  and  that  ter- 
minates into  a  cut  directly  at  right  angles  to  it,  which  cut 
interlocks  with  a  screw  as  periodically  the  spindle  is  rotated  in 
the  sleeve  or  tuhe  of  the  cuj). 

The  2)eriodical  interlocking  of  the  screw  on  the  spindle 
with  the  right  angle  cut  on  the  tube  of  the  cup,  furnishes  the 
necessary  jar  which  l)reaks  the  air  l)ul)l)les,  while  the  incline 
of  the  cup,  due  to  the  position  of  the  tuhe  upon  the  cover,  causes 
the  material  to  be  spread  in  a  very  thin  layer  over  the  inner 
surface  of  the  cup. 

The  little  alarm  clock,  which  has  ])een  set  before  operation 
was  begun,  will  at  the  end  of  five  minutes,  notify  in  no  uncer- 
tain terms,  that  the  investment  is  ready  for  use. 

The  power  is  turned  off,  and  the  cup  slipped  off  the  spindle 
and  opened.  The  mix  should  be  found  of  a  smooth  creamy  con- 
sistency. 

With  a  very  small  round  badger  l)rush  (the  smaller  the 
pattern,  the  smaller  the  brush  shouhl  be)  a  small  quantity  of 
the  mix  is  taken  up  from  the  surface  of  the  mass,  and  placed 
upon  the  wax  pattern  held  upon  tlie  crucible  former,  in  and 
around  every  corner  and  margin  of  it,  and  this  must  be  done 
with  a  gentle  but  contimious  stroke,  during  which  the  l)rush 
does  not  leave  the  body  of  the  i^attern.  AVhen  the  amount  uj^on 
the  brush  has  been  deposited  upon  the  pattern,  the  former  is 
made  to  take  up  a  somewhat  larger  amount  from  the.  surface 
of  the  mass  contained  in  the  cup. 

Again  the  l)rusli,  carrying  the  creamy  investment,  is  jilaced 
upon  the  pattern  and  again  it  is  made  to  travel  in  close  prox- 
imity to  the  wax,  dei)ositiiig  along  its  line  of  travel  the  smooth 


170 


CAST    UOLD    AND    POIU'FJ.AIX    IXLAYS 


5  13 


IXVIOSTMKXT,    OK    IIKI'IIACH  )l;^■,    ( 'O.M  l'(  )l '  X  I)  171 

rclVactoiy  ('oiiijxjuihI,  uiilil  tlii'  wax  patU'iii  is  wliolly  enveloped 
in  it. 

AVhen  tlie  Avax  lias  l)een  entirely  siii-i-oiinded  hy  investment, 
tlie  ('ru('il)le  former  is  "-rasped  witli  the  tlium!)  and  the  tirst  two 
tiiigcj-s  of  tlie  left  hand,  while  a  faintly  kiinrled  piece  of  steel  or 
brass,  or  a  nicdiuiii  ,i;i-aiii  file,  is  di-aw  ii  dowiiwai-d  upon  the  edft'e 
of  the  crueihle  fonnei'. 

Tlie  flask  is  now  ])hieed  on  the  ei-ucihle  former,  and  the 
rest  of  the  invcstin,!;'  eoni])onnd  is  allowed  to  run  into  the  flask, 
close  to  the  mar<;in,  and  away  from  the  ])att('rn.  AVlicn  tin* 
flask'  has  been  half  filled,  it  is  rotated  smartly  back  and  forth 
n])()n  and  around  the  crucilde  former,  to  insure  a  complete  fill- 
inf;-  of  the  flask  and  prevent  the  imi)risonment  of  air.  The  bal- 
ance or  other  lialf  of  the  flask  is  then  filled  with  the  still  finid 
mass. 

It  must  be  remembered  that  the  instrument  is  to  be  drawn 
downward  only  upon  the  crucible  former,  and  no  seesaw  motion 
of  tlie  file  or  knuil  a<»ainst  the  edf-v  of  the  base  nmst,  under  any 
circumstances,  be  indulfi,ed  in,  and  the  exercise  of  the  instru- 
ment against  the  crucible  former  nmst  be  exceedingly  careful 
and  gentle,  lest  the  pattern  be  caused  to  fracture,  at  the  point 
where  the  sprue  wire  has  entered  to  sui)port  it  upon  the  base. 

This  will  cause  the  finer  and  smoother  particles  of  the  mass 
to  deposit  themselves  closely  to  the  pattern,  and  insure  a  very 
smooth  mold  and  subsequently  a  very  smooth  cast. 

The  flask,  having  l)een  generously  filled,  the  invested  pat- 
tern is  now  placed  ui)on  a  glass  slab,  which  in  turn  is  deposited 
in  some  place  where  it  will  not  be  likely  to  be  disturbed  or 
jarred,  and  thus  it  nmst  be  allowtd  to  stand  until  complete  crys- 
tallization of  the  fluid  investing  compound  has  taken  place. 

Complete  crystallization  of  the  mold  will,  in  dry  weather, 
take  place  in  15  to  o.")  minutes,  the  time  varying  with  the  mass 
of  the  compound;  in  humid  weather  4.")  minutes  to  an  hour  may 
elapse  before  it  becomes  advisable  to  touch  the  flask  or  mold. 

The  correct  instant  luay  be  recognized  by  the  grayish  white, 
and  silky  a])])earan('e  of  the  sur])lus  ])resent  in  the  flask. 

AVitli  a  sharp  l^nirc,  the  l)l;i<h'  of  wliicli  must  bc^  longer  than 
the  diameter  of  the  flask,  this  sur2:)lus  is  removed,  so  that  the 
l)ottom  of  the  mass  is  level  with  the  circumference  of  the  metal 


172  CAST    GOLD    AND    PORCELAIN    INLAYS 

liask,  and  Avitli  this  object  in  view,  tlie  surplus  is  removed  with 
one  sweep  of  the  knife.  Xext  the  flask  is  grasped  in  the  left 
hand,  while  the  tliunil)  and  index  finger  of  the  right  take  hold 
of  the  crucible  former,  and  turn  it  uj^on  its  seat  toward  the  left. 
Because  of  the  cone-shaped  seat  of  the  sprue  within  the  crucible 
former,  the  latter  may  be  easily  removed,  carefully  cleansed 
with  a  l)rusli  under  the  running  water,  dried,  faintly  lubricated 
and  put  aside.  With  the  flask  forceps  held  in  the  left  or  right 
hand,  the  flask  is  grasped  midway  and  held  over  a  small  Bunsen 
flame,  in  order  to  heat  the  sprue,  that  it  may  be  readily  disen- 
gaged from  the  wax  inlay  embedded  in  the  mold.  This  is  ac- 
complished by  grasping  the  slightly  heated  sprue  wire  wdth 
the  thumb  and  index  finger,  and  gently  twisting  it  around  and 
outward.  Care  nuist  be  taken  that  the  edge  of  the  flask  is  clear 
of  any  matei-ial. 

SUMMARY  rOR  CHAPTER  X 
The  Investment,  or  Refractory,  Compound  • 

1.  ^Miat  is  the  purpose  of  investment? 

2.  What   is   meant   by   a   refractory    compound?     Why   is   such    a   compound 
necessary? 

3.  What  arc  tlie  ncccssarj'  requirements  of  an  investment  compound? 

4.  What  is  the  function  of  plaster  of  Paris  in  an  investment?     Name  the 
three  varieties  of  gypsum. 

5.  Name  the  other  materials  used  as  refractories. 

6.  Describe  the  manner  of  making  the  mi\-. 

7.  Describe  the  manner  of  investing  the  wax  pattern. 


CHAPTEII  XT 

THE  DRYING  OUT  OF  THE  ISIOLD  AND  THE  BURNING 

OUT  OF  ^rilE  A  VAX  MODEL 

Until  some  siioli  automatic  lieating  aj^paratus  as  sliown  by 
the  inventor  of  the  entire  process  is  readily  obtainable,  eacli 
man  engaged  in  the  work  of  restoring  broken-down  teeth  by 
means  of  cast  gold  inlays  will  have  to  make  the  best  of  the 
means  lie  has  at  hand  for  the  burning  out  process,  and  a  good 
serviceable  aj^pliance  can  be  constructed  from  a  medium-sized 
Bunsen  burner,  ui^on  which  a  spider  of  six-inch  diameter  is 
mounted;  over  that  a  piece  of  latticed  steel  may  l)e  placed,  and 
surmounting  this  a  sheet-steel  tube,  lined  with  asbestos,  if  pos- 
sible, and  provided  with  a  handle  at  its  center.  This  tube  should 
be  about  eight  inches  in  height. 

This  apparatus  should  be  placed  upon  a  piece  of  slate  or 
asbestos,  and  it  should  be  surrounded  by  a  piece  of  sheet  metal 
as  to  keep  all  sudden  draughts  away.  I  use  a  Platcheck  furnace, 
in  which  is  placed  a  piece  of  latticed  steel,  and  under  which  is 
adjustably  i^laced  a  i^owerful  Bunsen  flame. 

Tlie  furnace  itself,  as  is  sliown  in  the  illustration,  consists 
of  two  main  parts  hinged  together. 

The  lower  or  under  j^ortion,  which  furnishes  the  support 
for  the  flasks,  is  provided  with  legs  extending  outward  and 
downward  from  its  underside,  the  spread  of  the  legs  1)eing  suf- 
ficient to  exclude  the  possibility  of  upsetting  the  furnace  when 
the  tojD  or  cover  is  thrown  back. 

Both  the  upi)er  and  lower  parts  are  semicircular  in  shape, 
and  are  lined  with  fire  ])rick.  "When  the  furnace  is  closed,  the 
space  inside  of  it  has  the  appearance  of  a  hollow  globe,  or  very 
close  to  it.  It  may  be  readily  seen  that  in  this  way  a  muffle  with 
a  decidedly  advantageous  radiating  surface  is  obtained.  Sup- 
ported ui3on  a  little  rim  on  the  upper  i:>art  of  the  furnace  is  a 
funnel  of  a  three-inch  diameter  and  about  eight  inches  high; 

173 


17-t 


CAST    COLD    AND    r()i;ci:CAlX     IXCAVS 


tile  cliauK'tcr  oi'  the  runnel  gradually  (limiiislies  nntil  it  registers 
two  inches  at  its  extreme  height. 

Ujion  the  interlaced  steel  wire,  resting  n])on  the  fire  brick 
of  the  lower  half  of  this  furnace,  the  metal  flask  containing  the 
mold  is  jjlaced.  Here  the  first  step  in  guarding  against  too 
rapid  heating  must  take  place. 

The  l)UiistMi  burner  sliouM  l)e  set  to  one-third  of  its  capacity, 


Fig.  10(3. — Tag<;;irt  autoinatic,  (yas)  l)iiriu'r  for  iciikis  iiii;  w  iix  paltcni  I'l-nni 
mold.  The  gas  is  ma<lo  to  travel  tiirougii  tlie  clock  uliicli,  after  a  set  pcriml,  en- 
larges the  opening  ami  allows  the  flanic  to  increase.  Wlwn  tlie  flame  has  rrachcil 
its  maximum  ami  j-cmaini'd  at  this  Ihml^IiI  I'nr  li\c  niiiinlcs,  ii  is  aul  omat  ica  lly 
shnt   off. 


and  i)laced  hcnfalh  the  riifiiace.  The  flask  is  jjlaced  upon  tlu; 
latticed  steel  w  ii-e  I'l-aiue,  resting  on  the  insiih^  of  the  lower  part 
of  the  furnace,  and  as  I'ar  away  from  the  center  ol*  the  flame  as 
the  inner  periphery  of  1  lie  riiniace  will  pei-niit. 

The  JM-alcr  is  dosed  and  llie  flask  is  left  tliere  for  a  jxM'iod 


I)l;^•|^•(;   .mold  and  lu'itxixc   wax   modp:!. 


1  7.") 


of  ten  iniiiutes.  H*  after  tlie  liiiu'  iiieiitioiied,  we  open  tlie  fur- 
nace to  examine  llic  Mask,  w  c  will  lind  very  little  moisture  ris- 
inu'  from  tlic  Ixxlv  of  it,  hut  we  will  also  lind  a  constant  stream 


Fig.  1G7. — Platcheck  furnace  closed,  showing  flue,  or  chimney 


of  fine  vapor  escaping  from  the  sprue  hole  or  gate  in  the  niokl. 
This  is,  of  course,  due  to  the  volatilization  of  the  wax.    The  flask 


17(J 


CAST    GOLD    AXD    roilC'ELAlX    JXLAYS 


is  now  moved  u])  closer  to  tlie  center  of  conibnstion,  and  it  is 
best  to  evenly  divide  the  distance  between  tlie  perijDliery  of  the 
fnrnace  and  the  center  of  combustion,  and  place  the  flask  at  that 


VVfl.  l')8. — The  Platflicck  I'lirnai-c  for  lni?  iiiiiL',  nut  the  wax.  Furnace  (i|i('ii, 
showing  burner  under  it  and  ilask  upon  the  wire  net  ready  to  lie  sulijected  to  the 
flame. 


])oiiit.  At  the  sanu;  time  llic  biinicr  is  liinicd  on  lo  two-lliirds 
of  its  capacity.  Be  sure  of  a  slow  licat,  so  tiiat  the  moisture 
is  evaporated  rather  llian  steamed  oid. 


l)i;\i.\(;    Moi.i)  AM)   i!ii;xi.\(;   wax    modkl  177 

The  furnace  js  closed  and  allowed  to  remain  in  this  con- 
dition for  about  live  to  ten  minutes,  time  varyin<>,'  with  the  size 
of  the  llask,  wlien  the  furnace  is  again  opened  and  tlie  flask 
looked  at.  Tt  will  ))e  seen  that  tlie  cruci))le  Jias  over  it  a  coat 
of  carbon. 

AVlien  the  drying  jx'iiod  has  passed,  the  flask  is  placed 
directly  in  the  ceider  of  the  latticed  steel  wire  frame;  the  Bun- 
sen  flame  will  then  l)e  immediately  beneath  it.  Tlie  furnace  is 
closed  and  the  lUmsen  bui-nei'  is  adjusted  to  its  full  capacity 
for  one  or  two  minutes.  '^Phe  In^drocarbons  will  burst  into  flame, 
after  which  time  the  flame  under  the  furnace  is  extinguished 
and  the  furnace  o])ened,  to  reveal  a  mold  clear  of  carbon,  or 
any  other  deposit,  and  of  a  grayish  white  color,  speckled  here 
and  there  with  the  iron-gray  of  the  graphite. 

The  flask  is  carefully  grasped  with  the  flask  forceps,  lifted 
off  the  steel  wire  support,  and  carried  onto  a  seat  of  asbestos 
or  slate.  Either  of  the  foregoing  is  to  be  preferred,  to  iron, 
because  both  are  nonconductors  and  will,  therefore,  exclude  the 
possibility  of  too  sudden  a  thermal  change,  and  probably  hair- 
like fracture  of  the  mold. 

It  nuist  be  understood  that  at  no  time  has  the  temperature 
of  the  flask  been  raised  to  a  i)oint  that  would  make  it  red  hot, 
or  even  beyond  that. 

The  wax  advocated  for  use  in  this  book  will  volatilize  and 
disappear  at  such  a  comparatively  low  temperature,  that  it 
Avould  be  folly  to  subject  the  mold  and,  therefore,  the  plaster 
therein,  to  any-  uncalled  for  degree  of  heat. 

It  is  well  to  remember  that  the  le'ss  heat  Ave  employ,  the 
stronger  our  mold  will  l)e,  and  the  greater  its  resistance  to  in- 
ternal i^ressure,  and  the  less  distortion  Ave  shall  cause  inside  of 
the  mold. 

The  flask  is  now  alloAved  to  gradually  cool  doAvn  until  it  is 
the  same  temperature  as  the  air  in  the  room,  Avhen  it  Avill  be 
ready  to  be  put  into  the  seat,  on  the  machine,  in  order  to  re- 
ceive the  metal. 


CliAl'TER  XII 

'mis  C'AS^I^IXd  OF  THE  :\I()LTEX  I\rETAL  IXTO 
THE  MOLD 

We  are  coming-  to  the  elucidation  of  tliat  i3art  of  the  tecli- 
nic  of  the  casting  of  inlays,  Avliich  has  proved  the  most  active 
l)attle-gronnd  for  the  many  and  various  ojiinions  of  as  man}^ 
writers  njDon  tlie  subject. 

The  hot  mold  or  tlie  cold  mold,  the  expanded  mold  or  the 
normal  mold,  questions  -which,  in  the  minds  of  some,  occupy 
a  i^lace  of  prime  imj^ortance  in  the  art  of  casting,  and  I  Avould 
retrace  my  steps  a  l)it  and  bring  again  before  you  some  of  the 
telling  points  in  the  sequence  of  their  occurrence  in  these  vari- 
ous chapters. 

Let  us  all  remeni])er  tenaciousl}^  that  we  are  doing  our  work 
in  a  room  kept  at  a  given  temperature;  all  our  things,  instru- 
ments and  materials,  as  well  as  the  probable  patient  and  the 
tooth,  are  in  that  room  and  subject  to  that  temperature. 

The  cavity  is  prepared  and  we  are  ready  for  the  making 
of  the  wax  inlay. 

The  wax  is  softened  and  put  into  the  cavity,  cnid  it  is 
caused  to  harden  under  pressure;  it  is  chilled,  Avhile  a  force 
greater  than  the  intramolecular  attraction  of  it,  is  upon  it  to 
prevent  any  change  of  bulk  or  form. 

Once  cliillcd  1(^  jjrojxM-  size  and  tVictional  lit  of  cavity,  no 
change  of  form  or  bulk  of  the  Avax  can  take  ])lace  at  that  tem- 
perature. 

The  car\iiig  is  (•()ini»l('t('(l  and  ilic  iiday  is  invested  in  a 
compound;  the  powdci-  and  llic  li(|ui(l,  A\liicli  mak'e  up  this  com- 
pound, are  placed  in  a  bow]  oi-  mixer,  at  the  same  temperature 
which  the  wax  inhiy  has  been  subjected  to  right  along,  and 
which  tempei'ature  it  can  not  change. 

The  coni])onnd  ('()i]1ains  so  lillh'  of  Ihc  active  ])laster,  that 
practically,   no  heat    is  cvoKcfl   (hiiiiig  the  ])('riod   of  crystal- 

178 


CAS'I'IXC     MOI.TKX    .MKTAF.    INTO    .MOIJ)  J  79 

lizatioii  of  Uk'  mass.  'I'lic  wax  patlci'ii  in  lliis  mold,  llierefore, 
lemaiiis  iiiichaiiged.  Once  the  mass  is  eiystallized  around  the 
nnchanfted  wax  pattern,  we  are  justified  in  our  fixed  belief 
founded  uj^on  sound  reason,  that  we  have  a  normal  mold. 

A  fixed  belief,  rounded  uj)on  sound  icason,  means  nothing" 
short  of  definite  knowledge.  AVe,  therefore,  know  that  up  to 
the  i^resent  point  we  have  done  nothing  toward  ereating  or  call- 
ing into  existence,  any  condition  at  variance  with  these  that  are 
essential  to  keep  our  wax  pattern,  and  tlic  mold  in  wliicli  it  is, 
unchanging  as  to  bulk  or  shape. 

The  flask  is  now  placed  in  the  projjer  position,  within  the 
furnace,  the  heat  is  applied  and  gradually  increased,  until  the 
wax  lias  l)een  volatilized  completely;  and  with  the  application  of 
the  heat,  comes  the  change  in  the  size  of  the  mold  and  flask, 
which  gives  at  this  time  a  distorted  mold.  Note  the  word  dis- 
torted, for  this  is  just  what  I  mean  to  convey  to  you;  the  inlay 
is  not  made  larger  evenly  or  in  the  same  ratio  in  all  directions. 

Eefractory  materials  shrink  or  exjiand,  as  the  square  of 
the  mass,  but  if  we  remember  that  our  wax  i^atterns  are  not 
cubes,  or  balls,  or  just  fiat  surfaces,  or  star-sliajied  dreams  of 
even-jDointed  bliss,  we  shall  realize  that  perhaps  at  one  point  of 
the  circumference  of  the  wax  of  the  mass  surrounding  an  inlay, 
we  may  have  a  compound  one-fourth  inch  thick  and  one  and 
one-fourth  inches  high ;  while  at  the  next  point  of  the  circumfer- 
ence of  the  mass,  it  will  be  tliree-eighths  inch  thick  and  one  and 
one-fourth  inches  high;  at  a  third  point  of  the  circumference, 
it  may  l)e  one-half  inch  thick,  and  one  and  one-fourth  inches 
high;  while  on  the  crucible  side  we  may  have  it  one-fourth  inch 
high  around  the  entire  circumference,  and  one  the  reverse  side 
of  the  flask,  it  ma}^  be  a  solid  block  of  investment  one-fourth 
inch  deej)  l)y  one  inch  in  diameter. 

Where  the  compound  is  thinnest  in  bulk,  it  is  nearest  to 
the  brass  flask,  and  the  influence  of  the  metallic  ring,  as  an  aid 
in  distorting  the  compound  more  at  that  point,  will,  in  a  hot 
flask,  make  itself  felt  most  decidedly. 

If  we  admit  that  the  exjoansion  of  the  mold  at  the  thicker 
part  of  it  is  less  likely  to  l)e  influenced  by  the  metal  ring  (a 
reasonable  admission),  and  that,  therefore,  the  expansion  of 
the  part  of  the  mold  would  be  more  likely  to  take  place  in  ac- 


ISU  CAST    c;()Ll)    AX  I)    rOltCELAlX    IXLAYS 

cordaiico  with  tlie  recognized  laws  wliicli  govern  tlie  minerals 
that  make  up  the  mass,  then  we  must  have  an  exj)ansion  of  this 
mold  which  is  of  ver}^  marked  inequality;  in  other  words,  a 
distortion. 

Into  a  mold  so  distorted,  these  hot  flask  adherents  then  cast 
their  metal,  and  the  result  is  an  inlay  which  is  as  imequally 
enlarged  as  the  mold  was  unequally  distorted. 

All  the  disking  and  stoning,  and  cutting  and  trinuning,  can 
not  Ining  this  casting  l)ack  to  the  exact  form  required  for  that 
cavity,  for  clearly  no  means  at  our  command  can  make  this 
metal  assume  angles,  lines,  points  and  surfaces,  the  same  as  to 
size,  proportion,  and  direction  as  those  possessed  hy  the  wax 
pattern. 

The  fact  tliat  some  men  do  put  these  inlays  into  cavities 
proves  nothing  except  that  they  are  content  with  the  results 
they  obtain,  and  that,  of  course,  is  no  proof  of  the  correctness 
of  their  method. 

The  men  who  realize  the  truth  of  the  foregoing,  will,  after 
the  complete  volatilization  of  the  wax,  allow  this  flask  to  resume 
its  normal  size,  and  the  mold  within  to  come  hack  to  its  original 
proportions.  This  can  only  be  acconq^lished  by  allowing  the 
mass  and  flask  to  become  stone  cold;  that  is,  resume  the  room 
temperature. 

The  cohl  Hask  adherents,  realizing  that  the  correct  com- 
pound they  use  for  investment  is  so  well  balanced  in  its  com- 
ponents of  plaster  and  silex  that  the  expansion  of  the  latter 
nullifies  the  contraction  or  shrinkage  of  the  former,  are  content 
to  carefully  and  tlioi-oughly  volatilize  the  wax  and  allow  those 
two  comi^onents  to  return  to  their  oi'iginal  condition,  by  allow- 
ing the  mold  and  flask  to  rid  itself  of  its  heat.  Tlius  they  ob- 
tain, after  the  volatilization  of  the  wax,  a  mold  of  exactly  the 
same  size  as  the  wax  ])att('rn,  \\liicli  llicy  pnl  into  it,  and  which 
has  now  disa])])ear('(l,  and  this  mold  is  of  the  same  temperature 
now,  when  it  is  i-cady  for  the  metal,  as  it  was  when  it  contained 
the  wax  pattei-n.  It  was  unahic  to  alter  its  shape  and  ])i()|)or- 
tion  then;  it  is  unable  to  remain  distorted  Avhen  allowed  to  cool. 
The  accession  of  the  heat  which  caused  its  unequal  distortion, 
AvilJ,  by  its  gr;ulual  disap])earance,  compel  the  compound  to  re- 
sume  its  normal  condilioii.     I  tVcl  thai   I  can  not  he  loo  cmplialic 


CASTINC     .MOI/I'KX    .MKTAl.    IX'IO    .MOlJi  181 

about  this.  Xot  only  is  the  cold  llask  in  liai'nioii\'  with  the  ])liys- 
ical  laws,  but  it  has  |ii-o\(mI  itscll'  coi'i-ccl  in  this  ])i'aeti('al  woi'k' 
and  clinical  cxpi'iinicnts.  TIicn'  w  ho  rail  against  it  liavc  slij)])e<l 
up  somewhere  in  tlicii"  technic,  and  tlics-  ai-e  ])uttin<i,-  the  hhinic 
on  the  \vronf;'  shouldeis. 

Let  thcni  t  r>-  a;4ain,  woi'k  out  excry  stej)  carefully,  and  fol- 
low directions  iin])licit ly.  It  anIII  i>ay;  I'oi-  they  will  obtain  re- 
sults that  are  correct,  and  1  am  wiliiiiL;-  to  assume  that  they 
are  eager  for  such  results.  A  cold  llask  it  is  then,  at  least  for 
the  confines  of  this  xolunic,  and  t'oi-  those  who  desire  to  follow 
the  technic  outliiuMl  licrcin. 

Perhaps  it  will  he  as  well  to  say  here,  that  unless  every 
step  of  this  technic  he  carried  out  as  outlined,  1  consider  myself 
absolved  from  any  responsibility.  I  willingly  and  confidently 
promise  results,  providing  the  reader  will  follow  instructions  to 
the  letter,  but  1  will  not  submit  to  any  deviation  on  the  irdvt 
of  the  reader,  nor  will  1  brook  any  su])stitutions  for  portions  of 
this  technic;  no  short  road  to  Rome — no  better  or  quicker 
method  in  part.  If  any  supplanting  of  method  be  done,  it  must 
be  so  supplanted  as  a  whole. 

This  technic  interdigitates  and  dovetails  in  every  step  or 
degree,  and  it  has  l)een  carefully  worked  out  to  do  just  that. 
A  change  in  any  i)art  means  a  disturbance  of  the  equilibrium 
and  indifferent  results — something  to  be  avoided. 

SUMMARY  FOR,  CHAPTER  XII 

The  Drying  Out  of  the  Mold  and  the  Burning  Out  of  the  Wax  Model 

1.  Describe  a  simple  licatiiifj  apparatus  for  use  in  the  burning  out  process. 

2.  Describe  the  Platcheek  furnace. 

3.  Describe  tlie  uiaiiner  of  manipulating  the  flame  to  iiisurc  the  proper  dry- 
ing and  burning  out  witliout  brinuin"-  the  flask  to  a  red  hot  condition. 


CHAPTER  XIII 
THE  :\IETALS  FOR  THE  IXLAY  AVORlvER 

Tlioiigli  gold,  X'lt^tiiiiiiii,  silver,  copper,  and  all  tlie  metals  of 
the  i^latinum  groui)  have  their  measure  of  apj^lieation  in  inlay 
Avork,  only  gold  and  jjlatinnm  will  ])e  considered  for  the  pur- 
2)ose  of  this  work. 

I  want  to  lay  stress  npon  the  fact  and  have  it  clearly  un- 
derstood that  when  I  sjDeak  of  metals  at  all  I  speak  of  them  in 
a  pure  state,  or  rather  in  a  commercially  pure  state.  So  that  in 
considering  gold,  it  is  understood  to  be  pure  gold,  24  carat  fine, 
and  in  considering  j^latinum  it  is  understood  to  he  pure  plat- 
imim,  soft  platinum,  as  soft  as  the  refiner  can  furnish  it  in  sheet 
or  foil  state,  as  devoid  of  iridium  as  it  can  he  made. 

AVe  have  been  in  the  hal)it  of  speaking  of  metals  as  royal 
or  noble  metals  and  base  metals.  Royal  metals  are  capable  of 
being  separated  from  combinations  with  oxygen  by  merely 
heating  them  to  redness.  Base  metals  are  those  wdiose  com- 
pounds with  oxygen  are  not  decomposable  by  heat  alone.  Gold 
and  platinum  belong  to  the  royal  metals. 

Gold:  symbol  Au;  combining  weight  197.7;  fusing  point 
2004°  F.,  1050"  C,  specific  gravity  19.3  to  19.5. 

Platinum:  symbol  Pt;  combining  weight  193.3;  fusing  i)oint 
3225°  F.  to  3425°  F.,  1650"  ('.  to  1775'^  c]  specific  gi-avity  21.5. 

A  quantity  of  i)ure  gold  depending  U])()ii  the  needs  of  the 
case,  a  cei'taiii  amount  of  vei-y  tliinh^  rolled  out  platinum,  a 
seasoned  cliai'coal  block,  a  mixture  of  potassium  nitrate  and 
boi-ax,  two-tliii<ls  of  tlic  formci'  to  oiic-thii'd  of  tlie  latter,  wliicli 
is  contained  in  a  suita])le  receptacle,  a  ])aii'  of  brown  or  ambcj- 
colored  glasses,  a  nitrous  oxide  blow])i]y.',  a  ])aii'  oF  ])latiiiuiii- 
tipped  foil  cai-i-iei-s,  and  an  asbestos  or  slate  ])ad,  the  latter  t(r 
be  preferi'c*!,  niak-c  up  llic  necessary  iiictallui'gic  ('(luipmcnl  for 
a  laboratoiy  wii(.']-e  inlays  are  to  1)e  made 

The  gold  may  be  in  the  shaiM'  of  h('a\'\'  sheds  oi'  ingols, 
llic  j)laliiinm  must   he  in  cillicr  Ncry  thinly   ioINmI  oi'  Foil   Foi-m. 

382 


^NIKTALS    FOi;    TIIK    l^■|,A^•    WOllKKIt 


183 


A  seasoned  charcoal  Mock  is  one  wliicli  has  hccii  carefully  and 
gTadiially  lieaied  oi-  roasted  ovei-  a  h)\v  heat  until  the  danger 
of  its  disru])tion  when  suhjected  to  intense  heat  is  eliniiiuited. 
A  strong  co])per  wii-e  is  tlien  wound  around  tlu'  cliarcoal  ])h)ck 
and  the  loose  ends  of  the  wire  are  tied  With  a  suitahle  insti'u- 
nient  a  (k'pression  is  made  dee])  enough  to  hold  the  i-e(|uired 
({uantity  of  metal,  and  care  sliould  he  exei-cised  to  have  the  walls 
of  this  ini])ressiou  or  cavity  perfectly  smooth  and  to  have  no 
loose  l)its  of  carhoii  ])resent. 

If  we  are  now  to  alloy  a  certain  (juantity  of  gold  and  plat- 
inum, we  will  ])roceed  as  follows:  the  gold,  definitely  weighed, 
is  so  placed  in  the  crucible  that  all  of  it  lies  below  the  margin 
of  the  depression.     r>efor(^  ])i-oceeding  with   the  aj^plication  of 


Fig.  169. — A  charcoal  block  with  a  depression  in  it  to  act  as  a  crucible.  A 
copper  wire  tied  around  this  block  will  prevent  such  accidents  as  the  sudden  dis- 
ruption of  it  when  subjected  to  great  heat  at  one  point.  These  blocks  should 
be  thoroughly  seasoned,  as  explained  elsewhere  in  this  book. 


the  nitrous  oxide  blowi)ii5e  to  the  gold,  platinum  must  be  pre- 
pared tirst  by  cutting  it  in  very  narrow  strips,  not  over  Mg  or 
%2  of  an  inch  wide,  and  as  thin  as  it  can  be  obtained.  The  nec- 
essary cpumtity  of  this  material  is  now  i)laced  upon  a  sheet  of 
white  paper,  so  that  the  individual  ])ieces  may  be  easily  dis- 
tinguished. 

AVe  are  now  ready  to  proceed  with  our  melt.  The  city  gas 
is  opened,  and  the  tlame  is  lit,  the  nitrous  oxide  cylinder  valve 
is  opened  and  the  gas  is  allowed  to  How  into  the  mixing  cham- 
ber to  unite  with  the  city  gas  to  give  the  necessary  heat  units, 
so  as  to  efficiently  bring  the  metal  to  the  required  temperature. 


IS-i  CAST    c;OLL)    AXJ)    J'OKCELAIX    INLAYS 

Tlie  liottest  part  of  a  nitrous  oxide  tlaine  is  at  llie  first  tliird  of 
its  exit  from  the  l)lo\vi)ipe  and  the  successful  coml)ustion  of 
nitrous  oxide  and  city  (i,-as  is  one  that  consists  of  a  continuous 
pencil  of  a  clear,  bhush  green  tianie,  covered  by  a  short  mantle 
of  red  rays,  sparingly  distributed  round  the  bluish  green  tlame 
at  its  immediate  source,  and  reaching  onh^  for  al)Out  %  to  1  inch 
of  its  k^ngtli.  The  wliole  (hime  for  the  melting  of  the  metal 
in  the  crucible  should  be  al)out  4  inclies  long  and  this  necessi- 
tates the  reduction  of  the  supph^  of  city  gas  to  the  requisite 
amount. 

The  operator  must  now  don  his  amber-colored  glasses  and 
the  flame  is  now  played  on  the  gold  contained  in  the  crucible, 
the  flame  being  no  more  than  V/2  to  2  inches  away  from  the  gold. 

The  application  of  the  flame  must  be  constant,  the  hand 
nuist  be  steady,  and  there  must  be  no  drafts  in  the  room.  The 
first  sign  of  effective  work  will  manifest  itself  in  a  loss  of  def- 
inition as  to  outline  and  boundary  of  the  various  pieces  of  gold. 
They  will  ai^i^ear  to  collapse,  to  give  up  their  identity  and  will 
go  from  a  state  of  redness,  from  a  shapeless  to  a  spheroidal 
mass  into  a  state  of  incandescence,  thence  to  a  violet-colored, 
heaving  mass,  in  which  the  repelling  and  the  attraction  of  its 
component  molecules  seem  to  be  alternating  phenomena,  fol- 
lowing each  other  with  a  rhythmicity  and  a  i^eriodicity  which 
inight  be  definitely  measured  if  one  felt  so  inclined. 

At  this  time,  a  piece  of  the  narrow  platinum  foil  is  grasj^ed 
with  the  platinum-tipped  foil  carriers  and  fed  into  the  still 
constantly  boiling  mass  of  gold,  until  it  has  been  completely 
absorbed.  This  process  of  feeding  the  platinum  is  continued 
until  tlio  required  amount  of  this  metal  has  been  taken  up  by 
Ilic  laigci'  mass,  after  that  the  flame  is  still  held  over  the  danc- 
ing llnid  gold  and  it  is  kepi  in  n  \-i()l('iil  stale  of  agitation  for  a 
])eriod  of  time,  varying  directly  as  tlie  ((uantity  of  metal  being 
handled,  the  periods  l»eing  about  as  lollows:  1  oz.  of  au  alloy 
containing  jjure  gold  and  2]-2  to  .")  pei-  cent  of  ])latinum  nmst  be 
k'ej)t  after  tlie  entire  amount  of  platinum  has  been  tak'eii  up  by 
the  molten  mass,  in  a  state  of  constant  agitation  for  at  least 
two  minutes.  Tlie  ailo\-  will  be  nnieli  more  homogeneous  if  this 
pei'iod  is  prolonged.  If  the  allo\-  contains  a  gi'eater  percentage 
of  platinum,  hetween  T)  and    I'l   per  eciil,   the   pei'iod   of  time  I'O- 


.MK'r.\i>s   I'Oi;   TiiK   l.\•|.A^■    wokkki;  185 

(jiiircd  I'or  coiislani  ;i,ii,itat  ion  should  he  no  k'ss  than  live  min- 
utes. If  ilie  alloN'  conlains  a  (|uaii1ily  of  ])latinuni  '••reater  than 
10  pel-  cent  and  up  to  1.")  per  ccnl,  the  jieriod  of  a^'itation  is 
from  scNcn  1o  ten  ininulcs.  The  alloy  must  ))e  allowed  to  cool 
artci-  thai,  must  he  i-oMcd  out  into  sheets,  cut  into  small  sections, 
a.^ain  icmelted  and  a,i;itate(l  {'ov  I'l'om  seven  to  ten  minutes.  In 
a  certain  qualitx'  ol'  castin*^'  jL-old  used  which  among  other  things 
contains  19  pei-  cent  i)latinum,  which  ])latinum  in  turn  contains 
2  ])er  cent  iridium,  the  mass  is  fused,  the  i)latinum  is  fed  in, 
then  tlie  entire  mass  is  agitated  for  lifteen  minutes,  an  ingot  is 
made  and  this  i-oHed  out  into  sheets,  then  remelted,  etc.  This 
jjrocess  is  repeated  four  times  and  the  period  of  agitation  is 
longei'  each  time,  so  that  at  the  fourth  time  the  period  lasts  be- 
tween twent^^-tive  and  thirty  minutes. 

AVlien  the  jjeriod  of  agitation  has  i)assed,  the  flame  is  ex- 
tinguished, the  mass  is  allowed  to  cool,  and  it  is  not  to  he 
touched  until  it  has  thoroughly  crystallized,  when  it  inay  he 
l)icked  up  with  the  platinum-tipped  foil  carriers  and  jjlaced  into 
a  hydrochloric  acid  hath,  and  then  rinsed  with  plenty  of  cohl 
watei-.  If  the  quantity  of  metal  is  an  ounce  or  nearly  an  ounce, 
it  may  he  divided  into  four  imvt^  by  using  the  cold  chisel  and  the 
hammer.  The  anvil  nmst  he  clean  and  a  sheet  of  Avhite  i)ai)er,  or 
l)etter,  cardboard,  nmst  l)e  ])laced  ui)on  it.  AVlien  the  nuiss  has 
been  separated,  each  individual  piece  must  be  first  boiled  in 
nitric  acid,  then  washed  in  water,  then  melted  in  the  charcoal 
l)lock  with  the  nitrous  oxide  blowpipe,  agitated  for  a  minute  or 
so,  allowed  to  crystallize,  transfen-ed  to  the  hydrochloric  acid, 
again  thoroughly  washed  in  water,  and  put  away  for  future  use. 

No  surplus  of  any  casting  should  be  used  again,  unless  it 
has  been  retined  by  thoroughh^  fusing  it  and  si3rinkling  it  lib- 
erally with  the  powders  contained  in  the  receptacle  holding  the 
potassium  nitrate  and  borax.  The  melting  process  from  then 
on  is  continued  as  is  the  period  of  agitation,  as  previously  out- 
lined. 

Gold  for  inlays  for  j^atients  Ijetween  twentj^-five  and  forty- 
five  years  of  age,  where  teeth  are  in  fairly  normal  occlusion : 

Pure    ooM    4n.')i/^   grains 

Pure  platinum    HVi       " 


18G  CAST    GOLD    AXn    roRCELATX    INLAYS 

Cold  for  inlays  for  ijatients  wliere  teolii  are  in  malrelation 
and  where  the  stress  of  occlusion  is  varyin.i;-  in  direction  and 
very  intense : 

Pure    gold    450  grains 

Pure   iilatiiuiiii    24       " 

Gold  foi'  inlays  for  teeth  in  normal  occlnsion: 

Pure   gold    4921/^   grains 

Pure  idatinuiu    7^2       " 

liuld  for  inlays  for  teeth  that  are  very  frail: 

Pure    gold     432       grains 

Pure  platinuu]    38 1/2       " 

Pure   silver    91/2       " 

Ciold  for  cast  bases: 

Pure    gold    456  grains 

Pure   platimiiii    24       " 

(iold  for  saddles: 

(1)  Pure   gold    384  grains 

Platinum    2%    iridium     ....    72       " 

Pure  silver 18       " 

Pure  copper    (5       " 

(2)  Coin    gold    432  grains 

Platinum   2%    iridium    48        " 


SUMMARY   FOR   CHAPTER  XIII 
The  Metals  for  the  Inlay  Worker 

1.  What  metals  arc  comm.only  tisccI  by  the   iiday  worker? 

2.  What  are  the  materials   and   the   instruments   necessary   fo   maki'   a    com- 
plete nictallurgic  equipment? 

3.  In  Avliat  form  should   gold  and  platinum,  rcsiicctively,  be  used? 

4.  Descrilic  the  making  of  thf  melt. 


CIIAITKK  X\V 

THE  CASTJXC  OK  ^FUE  MOLTEX  MKTAL  INTO  THE 

MOLD  AND  A  (OXSIDERATIOX  OF  THE  VARIOUS 

,A[AC^HIXES  EMPLOYED 

At  tliis  stage  of  tlie  work  we  are  ready  to  ])iit  our  cold  llask 
into  tlie  seat  of  the  iiiacliine  with  whieli  the  casting-  is  to  he  done, 
and  hefore  we  do  tliat  k4  ns  consider  and  carefully  examine 
some  of  the  things  that  have  l)een  said  in  regard  to  the  casting 
of  gold.  AVe  shall,  however,  first  establish  the  truth  of  the  fol- 
lowing statement : 

"All  metal  castings  are  made  under  jDressure." 

It  must  be  apparent  to  anyone  who  thinks,  that  even  if  no 
apparatus  of  any  kind  is  used  in  forcing  metal  into  a  mold, 
there  is  still  the  ])ressure  of  the  falling  metal  to  be  accounted 
for.  It  matters  not  what  we  call  it,  gravitation,  or  anything 
else,  the  fact  remains  that  what  we  are  trying  to  put  into  the 
receptacle  has  some  weight,  and  if  this  weight  is  great  enough 
to  overcome  the  resistance  of  the  air  in  the  mold,  and  if  the 
mold  be  joorous  enough  to  allow  that  air  to  escape,  then  we  shall 
have  a  casting,  and  the  very  fact  that  we  get  a  casting,  proves 
that  the  resistance  of  the  air  was  overcome,  and  to  overcome 
resistance  we  must  have  pressure. 

Of  course,  the  relation  l)etween  the  size  of  the  gate  in  the 
mold,  and  the  success  of  the  casting,  with  what  may  l)e  called 
the  inherent  jjressure  of  the  metal,  is  a  factor  to  be  carefully 
taken  into  consideration.  The  gate  must  be  larger  in  casting 
by  this  method  than  it  would  have  to  be  if  we  had  the  aid  of 
some  outside  agent  to  increase  the  i:)ressure,  and  confine  it  to 
a  circumscribed  area. 

It  is  not  advisable  to  use  this  method  in  casting  any  of  the 
royal  metals,  because  of  the  excessively  high  fusing  point  of 
these  metals,  and  the  ahnost  impossible  task  of  keeping  these 
metals  at  a  temperature  required,  in  order  to  have  them  fluid 

1S7 


188  CAST    (.lOLD    AXl)    roiU'liLAlX    IXIAYS 

enough  for  a  long  enough  period  of  time  to  conix)lete  a  casting 
by  this  metliod. 

It  lias  been  and  is  being  enij)l()yed  in  casting  low-i'using 
alh)ys,  used  in  the  laboratory  for  lower  dentures.  Most  men 
Avill  be  familiar  with  the  metliod;  that  is,  the  preparation  of 
tlie  model;  the  making  of  the  wax  pattern,  with  its  tAvo  in- 
verted, cone-shaped  extensions  at  the  condyles;  the  investment 
of  this  model  carrying  this  2)attern  into  one-half  of  a  sj^ecial 
tiask  in  such  a  manner  that  only  half  of  the  wax  j^attern  and 
inverted  cone  extensions  will  be  embedded  into  the  plaster  and 
sand,  the  su])sequent  lubrication  of  that  half  of  the  investment 
and  wax,  and  tlie  placing  and  filling  with  plaster  and  sand  of 
the  other  half  of  the  iiask,  the  drAdng  of  the  flask  containing 
the  invested  i^attern  and  model;  the  opening  of  the  flask  and 
the  boiling  out  of  the  wax;  the  careful  drying  out  of  the  mold 
until  th(^  mirror  test  shows  it  to  be  devoid  of  moisture,  and 
finally  the  melting  of  the  alloy  in  a  suitable  crucible;  the  as- 
sembling of  the  two  halves  of  the  flask,  and  the  pouring  of 
tlie  molten  alloy  into  one  of  the  funnel-shaped  openings  at  one 
side  of  the  flask,  until  we  see  the  metal  rise  in  the  funnel-shaped 
openings  at  the  other  side  of  the  same  flask. 

If  the  side  of  the  flask  which  contains  the  funnel-shaped 
opening  in  which  the  metal  rises,  were  longer  by,  let  us  say, 
an  inch,  than  the  side  which  contains  the  funnel-shaped  opening, 
into  or  by  way  of  which  we  pour  the  metal,  we  could  continue 
the  pouring  until  the  metal  on  tlie  escape  side  had  risen  a  full 
inch  higher  than  the  metal  on  the  intake  side.  If  there  were 
no  inherent  pi'essure  in  the  metal  being  poured  into  the  intake 
side,  til  is  could  not  take  place,  and  it  is  also  true  that  this  pres- 
sure is  as  the  weight,  and  is,  of  course,  partly  subject  to  the 
same  laws  as  those  wliicli  goNci'ii  railing  bodies. 

I  lliiiilv-  it  is  pretty  Avell  proved  that  casting  as  described 
above,  is  ])ressure  casting;  and  I  think  also  that  T  can  save  s])ace 
and  time  l)y  simply  stating  tliat  the  metliod  described  above 
is  entirely  and  absolutely  unlit  for  the  casting  oi'  inlays,  willioiit 
goin;^-  into  an_\'  lengthy  dissertation  as  to  why  this  is  so. 

What  is  ti-ue  of  the  simjile  j^rocess  above  descriljed,  holds 
good  in  dental  casting  by  iiieans  of  centril'iigal  force,  Avhether 
\\'e  make   use  of  one  of  the  een  t  I'i  Cnual    castinLi-   nia<'liines  sold 


CASTIXC    .MOI/I'KX     .MKrAL — M  A( '  1 1  I  N  KS    KM  |•|.()^  KD  189 

for  tliis  i)iirj)()S(',  or  sim])ly  swiii^'  a  hiicUct  (M^iitaiiiiii;;'  tlic  mold, 
and  the  molten  metal  in  a  circle  with  sufificient  rapidity  to  cause 
this  molten  metal  to  hui'v  itself  in  the  space  provided  in  the 
mold. 

That  this  <'enti'iru<;al  t'oi-ee  innst  he  convei'ted  into  pres- 
sure hefore  it  can  canse  the  metal  to  seek  the  cavity  in  the  mold, 
is  proved  by  the  fact  that  all  forces  tinally  expend  themselves 
in  i)ressure  of  one  kind  or  another,  so  that  a  casting-  made  by 
the  centrifugal  method  is  essentially  a  pressure  easting,  and  if 
this  centrifugal  force  could  in  any  way  be  definitely  confined 
and  doled  out  in  given,  definite,  and  measurable  quantities,  it 
would  have  i)oints  in  favor  of  its  use.  At  present  I  know  of  no 
apparatus  in  which  this  pi'iiici])h^  is  utilized  tliat  could  be  said 
to  be  deiDcndable  enough  to  warrant  its  use  in  the  casting  of 
gold  inlays.  No  claim  made  ])y  the  vendors  or  manufacturers 
of  these  centrifugal  casting  machines  has  been  sustained.  The 
quantity  of  the  force,  and  hence  the  amount  of  pressure  used, 
being  unknown,  the  best  one  can  say  of  the  possible  result  is 
that  it  will  be  doubtful.  I  used  one  of  these  machines  alongside 
of  many  other  makes,  and  after  careful,  conscientious  efforts, 
I  was  forced  to  the  conclusion  that  no  accepta])le  inlay  can  he 
made  by  this  process.  The  machine  has  its  use  perhaps  in  the 
arts  and  crafts  of  jewelry  castings,  and  in  coarse  laboratory 
work,  where  things  cast  may  afterwards  be  filed  out  to  definite 
measurements,  but  it  is  not  to  be  considered  for  inlay  work. 

The  most  commonly  employed  centrifugal  machine  consists 
of  a  base  with  a  cenliifugal  j^ivot,  to  which  is  fastened  one  end 
of  a  coiled  spring  and  a  flywheel  with  a  recess  in  the  under  side. 
This  flywheel  is  mounted  movably  upon  this  central  pivot  of 
the  base,  and  the  coiled  spring,  one  end  of  which  is  fastened  to 
the  central  jiivot,  is  attached  at  the  other,  or  outer,  end  to  the 
tly wheel,  and  enclosed  in  the  recess  of  it.  Externally  to  the 
frame  or  base  is  a  bar  which  actuates  a  leather-covered  lever 
arm  which  coacts  with  the  flywheel  to  hold  it  in  a  given  position 
after  the  spring  has  been  wound  up.  This  inakes  uj)  the  en- 
closed mechanism  of  the  machine. 

The  exposed  jjart  consists  of  an  arm,  fastened  to  the  fly- 
wheel by  means  of  screws,  entering  a  small  cylindrical  por- 
tion of  this  flywheel.    A  i)ivot  about  three-c[uarters  of  an  inch 


],[){)  CAST    UOLl)    AND    PORCELAIX    JNIAVS 

in  lioiglit,  rises  from  tliis  crossann  and  serves  as  a  handle  to 
wind  np  tlie  spring  by  rotation  of  tlie  fiywlieel.  On  eacli  end 
of  this  crossann,  is  a  lieaded  rivet  npon  Miiich  a  sliding  ad- 
justable arm  is  carried,  and  one  of  these  end  arms  carries  the 
tray  which  contains  the  flask  and  mold,  while  the  other  one 
carries  the  counterbalance. 

When  the  mold  is  ready  to  be  filled,  the  flask  is  slipped 
into  the  carrier  on  the  end  of  the  mold  arm.  The  sj)ring  hav- 
ing been  wound,  the  adjustable  arms  are  set  at  right  angles  to 
the  crossbar,  or  very  nearly  right  angles.  The  crucible  in  wdiicli 
the  gold  is  to  be  melted  is  placed  upon  the  carrier  immediately 
in  front  of  the  flask.  The  gold  is  melted,  and  when  it  boils,  the 
flywheel  is  released,  which  sets  it  in  motion,  which  motion  is 
transmitted  to  the  crossann,  and  from  it  to  the  end  placed  ad- 
justable anns,  which  immediately  straighten  out,  with  tremend- 
ous outward  motion,  and  this  forces  the  molten  metal  into  the 
mold. 

In  a  few  moments  the  maximum  velocity  will  have  been 
i-eached,  and  from  this  point,  the  sj^eed  of  the  machine  will 
decrease.  It  may  be  either  allowed  to  spend  itself,  or  it  may, 
after  one  and  one-half  minutes  be  stopped  l)y  pushing  the  leath- 
er-covered lever  against  the  flywheel. 

The  manufacturers  of  this  machine  claim  that  the  force 
may  be  modified  by  fewer  windings  of  the  spring,  and  while  this 
is  undoubtedly  correct,  the  pressure  produced  remains  indefinite 
and,  therefore,  not  suitable  for  our  purpose. 

Willi  tlie  greatest  care  used  in  every  step  of  the  work,  all 
iidays  made  were  more  or  less  irregularly  distorted,  due,  no 
douljt,  to  a  forced  readjustment  of  the  walls  of  the  inside  of 
the  mold,  this  readjustment  being  actuated  by  the  impact 
created  first,  by  tlie  violent  straightening  of  lli<'  ai-iii,  and  its 
consequent  sli])ping  upon  the  i)ivot,  and  second,  by  tlie  impact 
of  the  metal  against  the  wall  of  their  frail  investing  comi)ound. 

Wliile  the  defective  investment  may  be  eliminated,  the  agi- 
tated mold  icmains  as  a  permanent  deleterious  agent  in  the  ]n\'^- 
enl   macliine,  and  il   seems  (h)ul)trnl  il'  it  ever  can  be  remedied. 

If  tlus  njacliine  is  to  take  a.  lasting  j)lace  in  the  art  (.1* 
casting  inlays,  I  Avould  suggest  that  a  (h^viee  be  added  to  it  that 
would  enable  llii'  opei'aloi'  lo  so  wind  llie  spi-ing,  and  so  set  the 


CASTIXC     .M(H;i"KX     MI/IAI. — MACIilXKS    K.M  IM.ONKD  IDl 

llask  that  both  the  iiioiiiciituiii  ol'  the  ilywliccl  ami  tlie  sliock 
w  itii  w  liicli  the  flask  is  caused  to  straighten  or  throw  itself  away 
IVoiii  the  center,  may  he  ineasnred.  Tliis  is  not  at  all  inipossihle, 
and  simply  means  a  year  oi'  so  ol*  constant  ex])ei"inient  and 
mathematical  dcdnction.  'Plic  mannl'acturers  wonM  tlien  liave 
a  product  which  they  would  he  justified  in  offering  to  the  pro- 
fession for  accuiate  work,  jn-ovided,  of  course,  that  their  experi- 
inents  did  not  coin])el  their  honest  conclusion  that  at  its  hest  the 
machine  would  he  unlit  for  inlay  woi'k. 

liegardless  of  any  assertions  to  tlie  contrary,  most  vehe- 
mently made  ])y  the  maruifacturers  of  the  vacuum  machines;  they 
aic  nothing  else  than  pressure  machines;  and  in  order  to  prove 
this,  it  is  only  necessary  to  c[Uote  a  small  ])ai-t  of  tlndr  glowing 
literature  full  of  little  jokes. 

''Not  the  slightest  fraction  of  an  ounce  of  artificially  pro- 
rhircd  pressure  is  applied  at  any  stage  of  the  casting  operation, 
A\lien  an  Elgin  is  the  apparatus  used.  There  is  not  the  slightest 
fraction  of  an  ounce  of  artificially  produced  resistance  to  he 
overcome,  hecause  the  air  in  the  mold  is  removed  in  advance, 
and  is  not  sid)ject  to  compression. 

"Pressure  is  not  necessary  hecause  there  is  no  resistance. 
There  is  no  resistance,  the  air  necessarily  and  naturally  is  re- 
moved in  advance  of  the  entrance  of  the  metal,  through  the 
pores  of  the  investment  material  which  are  plenty  large  enough, 
no  matter  how  small  they  may  he,  to  permit  the  instantaneous 
passage  of  the  air  in  response  to  the  pull  of  a  vacuum  formed 
beneath  the  mold,  a  pulling  force  more  than  double  normal  at- 
mospheric pressure."  (Dental  Casting,  1912,  The  Ransom  & 
Eandoljoh  Com^iany.) 

If  any  evidence  he  needed  to  prove  that  the  suction  ma- 
chines are  pressure  machines,  the  little  hooklet  containing  the 
ahove  quotation,  and  many  other  sayings  quite  as  contradictory 
will  supply  that  evidence  gratis. 

Just  think  of  this  wonderful  pulling  force,  dragging  on  the 
vitals  of  the  mold,  and  keeping  up  this  drag  even  after  the 
gold  begins  to  enter,  with  a  force  equal  to  douhle  that  of  at- 
mosjjheric  pressure,  to  wit:   thirty  pounds  to  a  square  inch. 

Of  course  as  fast  as  this  machine  sucks  the  air  through 
the  mold  and  creates  a  vacuum,  the  atmosjjhere  ahove  would 


191^ 


CAST    eiOLL)    AND    POltC'ELAlX    IXLAY.S 


1)0  inert  if  it  did  not  i^usli  or  ijress  the  gold  into  tliis  vacuum 
much  abhored  by  nature;  and  because  this  j^ull  is  so  strong, 
in  other  words,  because  this  sucking  apparatus  is  so  voracious. 


Fig.  170-J. — The  Elgin  vaciiuni  cnstiiig  macliiiic  and  llasl<.s. 


Fig.   MOIi. — SaiHf   iiiarliiiic  us   in    l-"ig.    I7(i,/,    ri'mly    Inr   casting. 


th(!   aljused   and    harassed    aliiios])li('i('    nhove    must   exei-t    this 
tliirty  pounds  to  the  sriuarc  inch  in-cssiiic  i/alrns  rolens. 

All  1lii>  linn'  IIk-  imoIcciiIjii-  inlcuritN'  of  llic  mold   is  being 


CASTIXd     MOI/l'KX     .MKTAl, MACIIIXKS    KM  Pl.OVKI)  193 

attacked  l)y  this  plus  siidion  in  oidci'  to  allow  tlie  gold  to  enter 
witlioiit  any  diu'ess  exce])t  the  doultlc  atmospheric  pressure,  the 
])iill  of  the  ])Ius  suction  e(iuals. 

it  will  he  well  to  note  tliat  the  natural  atmospheric  pres- 
sure ui)on  the  earth  at  oui-  level  is  al)out  fifteen  pounds  to  the 
square  inch,  and  anything  ahovc  that  is  an  artificially  produced 
])ressure,  whieh  makes  their  statement  in  the  heginning  of  the 
quotation,  seem  veiy  far  from  an  accurate  scientific  assertion. 

To  cite  another  quotation  with  the  reader's  indulgence, — 
hut  first  the  digression  to  recall  to  your  mind  that  we  must 
thresh  these  things  out  to  settle  them,  for  at  least  some  time  to 
come, — it  will  ])e  well  to  quote  from  the  same  booklet,  page  4, 
beginning  on  line  25: 

''In  casting  by  other  than  the  vacuum  method,  the  excess 
metal  in  the  crucible  is  the  first  to  solidify,  tliere])y  shutting 
off  the  pressure.  Pure  gold,  especicdJi/  slirinks  in  the  process 
of  hardening,  and  with  the  excess  solidified,  and  the  pressure 
removed,  the  metal  in  the  mold  contracts  to  the  extent  of  the 
sJirnikar/e. 

"With  the  Klgin,  the  first  portion  to  harden  is  the  metal 
against  the  outer  walls  of  the  mold,  and  the  last,  the  excess  in 
the  crucible,  while  in  all  other  forms  of  cdsthuf,  the  process  is 
reversed. 

"In  using  the  Elgin  api)liance,  the  excess  can  be  kept  mol- 
ten, and  the  suction  maintained,  as  long  as  required  for  the 
metal  to  completely  harden  in  the  mold.  Simultaneously  with 
the  shrinkage  taking  j^lace  in  the  mold,  the  vacuum  draws  metal 
from  5'^//^  molten  excess  to  fill  the  space  left  by  the  natural 
shrinkage." 

The  colossal  imi^ertinence  of  sending  a  booklet  containing 
such  statements  to  men  who  are  supposed  to  have  had  at  least 
a  primary  lesson  in  metallurgy,  can  only  be  accounted  for  in 
two  ways :  It  may  be  that  the  man  that  wrote  this  statement 
in  the  Koranic  booklet  really  l)elieved  he  was  telling  the  truth, 
and  it  may  be  that  if  he  knew  he  was  Avrong,  he  figured  that 
none  of  the  men  would  read  it  with  enough  attention  to  find 
the  pig,  and  if  they  did,  they  would  not  know  the  difference 
anyway. 

I  have  seen  beautiful  jewelry,  such  as  elks'  heads,  cast 


liU  CAST    GOTJ1    AXD    ronCFJ.AlX    IXT.AYS 

Upon  an  El^iu  iiiacliine,  hut  1  liavc  iicvor  yet  in  my  ])ra('ti('e, 
l)fcx^n  called  ui)on  to  insert  an  elk's  liead  into  a  patient's  tooth, 
to  take  the  i)lace  of  an  inlay.  J  have  seen  (Jreek  letters  and 
coiled  springs  and  scimitars  Avhich  were  sucked  into  an  Elgin 
and  atmosjihered  twice  over  again,  hut  none  of  those  things 
have  ever  heeii  called  ui)on  to  measure  up  with  any  mici'ometer 
measurement. 

It  will  he  well  foi'  the  student  and  i)ractitioner  to  hear  in 
mind  that  we  are  called  upon  to  inlay  teeth,  and  to  inlay  them 
with  mieroscoi3ic  correctness.  True,  we  can  appreciate  fine 
jewelry,  nice  rings,  decorated  with  figures  or  hieroglyphics,  and 
no  douht,  if  we  ever  leave  our  profession  to  enter  the  field  of 
tlie  art  metal  worker,  these  machines  may  have  their  uses,  hut 
so  far  as  I  have  been  ahle  to  deternune,  they  are  failures,  and 
an  ordinary  little  swage,  with  its  air-comi^ressing  interior,  is 
to  he  preferred. 

The  vacuum  machine  is  a  pressure  machine;  of  that  there 
is  no  douht,  and  if  it  were  not  such  an  inverted  i^ressure  ma- 
chine, it  might  he  useful. 

I  take  it  that  the  reader  Avill  have  come  to  the  conclusion 
that  I  am  an  advocate  of  a  direct  pressure  machine,  and  this 
conclusion  is  sound.  I  have  my  reasons,  too,  for  jDref erring  and 
using  and  advocating  the  direct  pressure  machine,  provided  it 
is  the  right  kind.  The  right  kind  of  pressure  machine  is  one 
which  will  perform  the  following  service: 

It  must  ena))le  one  to  melt  tlic  gold  in  the  crucihle  of  the 
flask,  hefore  the  investment  in  this  flask  gets  hot  enough  to  dis- 
tort the  mold,  and  this  means  that  it  must  have  an  oxyhydrogen 
or  nitrous  oxide  hlow})ipe.  It  must  furnish  me  with  a  means 
to  definitely  know  how  mneh  ])ressure  1  am  using  foi-  casting, 
and  I  nuist  he  enahleil  to  sustain  that  pressure  at  w.ill;  and  I 
must  he  enahled  to  apply  that  pressure  at  the  psychologic  mo- 
ment. 

These  things  a  pressure  machine  mnsl  do  or  it  will  he  use- 
less. AVliat  otliei-  things  it  may  do  in  addition  to  those  men- 
tioned, are  a  inatter  of  refinement  of  detail  and  economy  of 
operation,  and  are  of  course  factors  wliicli  det<'rmine  one  in 
the  purcliase   of  any   mcrcliaiidisc,   hut    iliey   aic   not   al)Solute 


CASTIXC     .MOLTKN     MK'I'AI. .MACIIIXKS    K.M  IM  ,( )^  Kl )  ]!).") 

essentials    lo    perTccl    rcsull.s   wliik'   llic    lirsl    iiieiitioiicd   things 
arc  a))S()liil('ly  so. 

Xow.  hd'oi-c  lakiii,!;'  U))  direct  ])ressure  iiiacliiiies,  suppose 
we  (luiekly.  hut  t liorou^lil y,  coiisidei'  some  of  the  ])lieiioiiieiia 
Avliicli  take  place  in  tlie  castiii,!;-  of  ;;()ld  iiiidei'  jjivssure. 

Tile  rollowiiii;,-  is  a  ([uotatioii  in  ])ait  IVoiii  a  treatise  wi-itteii 
by  ('.  .].  ('lai'k,  of  Cliiea^o,  Illinois. 

"Foi-  countless  a;;'es  tlie  luatter  of  tlie  eai'tli  existed  in  a 
Hiolt'ii  state,  <;radually  coolini;-  and  sliiiidvin^-  until  tlie  surface 
became  I'id^^ed  and  the  intei'nal  molten  mass  ])ecanie  encapsuled 
hy  a  ci'ust.  As  the  shrinka<;e  continued,  matter  was  calh'd  upon 
to  sui)i)ly  the  deliciency,  and  the  crust  Ijcinf*-  solid  and  ri^id, 
and  held  by  the  j^ower  of  cohesion,  the  j^ower  of  the  centrifugal 
force  was  the  greatest  at  the  greatest  circumference,  and,  of 
course,  the  portion  of  tlie  revolving  s])here  that  offered  the 
least  resistance  (tlu^  jjoles)  succuniljed  to  the  demands  of  the 
intei-nal  shrinkage  and  were  drawn  inward;  and  so  we  find  the 
eaith  llattened  at  the  poles. 

"The  cooling  of  a  metal  in  a  mold,  wliih-  not  exactly  similar, 
is  strikingly  analogous  to  the  cooling  of  a  ])lanet  or  the  earth 
on  which  we  live. 

"Matt«u'  is  never  at  rest,  the  atoms  comprising  the  mole- 
cules revolving  around  a  connnon  center,  forming  a  miniature 
solar  system,  are  in  a  constant  state  of  agitation,  moving  rajoidly 
around  in  their  medium  in  ether,  and  confined  in  their  move- 
ment to  their  limited  space  between  their  fellows. 

"The  outer  surface  of  a  mass  of  matter  is  the  first  to  be 
susce])tible  to  any  thermal  change,  the  eifect  being  transmitted 
to  the  center,  and  if  this  thermal  change  of  sufficiently  bigh 
degree  to  change  the  state  of  the  mass  fi'om  the  solid  to  the 
liquid,  or  gaseous,  or  vice  versa,  the  su]7)lus  is  the  first  to  exhibit 
these  manifestations. 

"Let  us  suppose  a  cross  section  of  a  gold  plate  is  being  sub- 
,iecte(l  to  heat  of  sufficient  degree  to  induce  a  change  in  its 
l)hysical  structure,  the  atoms  of  the  molecules  revolve  more  raj)- 
idly  than  before,  become  more  diverging  in  their  tendency,  de- 
scribing a  large  circumference  about  their  common  center,  the 
molecules  increase  in  the  same  i)ro])ortionate  volume,  and  their 
mutual   ])()\V(M'  of  cohesion  diminishes.     This  allows  the  mole- 


1i)(i  CAST    (iOLD    AND    I'OIU'KLAIX     IXIAYS 

eules  to  sej)ai"at(.'  more  widely,  and  pennits  of  a  ^roatei'  latitude 
in  wliicli  to  exercise  tlieir  mobility.  As  the  atoms  are  whirling" 
aliout  tlieir  common  center,  the  molecules  are  revolving  and 
revolving  also  about  each  other,  generating  centrifugal  force 
to  such  an  extent  as  to  overcome  the  force  of  gravity,  and  with 
a  tendency  towards  projection  in  every  direction  held  in  re- 
straint only  by  the  still  active  though  much  weakened  power 
of  cohesion. 

"This  causes  some  molecules  to  l)e  lifted  above  their  fel- 
lows, and  as  the  heat  increases,  the  mass  begins  to  assume  a 
globular  shape  or  form  and  jiresents  a  panorama  of  rhythmic 
harmonious  action. 

"Xow  if  the  heat  l)e  withdrawn,  the  revolutions  of  the  atoms 
about  tlieir  common  centers  decrease,  and  as  their  momentum 
gradually  diminishes,  the  atoms  come  into  closer  proximity,  the 
molecules  decrease  in  volume,  the  i^ower  of  cohesion  increases, 
tile  iiiutual  attraction  of  the  molecules  becomes  more  intense, 
exhibiting  more  influence  than  the  force  of  gravitation,  and  the 
congealing  mass  of  metal  retains  more  or  less  of  the  glolmlar 
form,  the  molecules  being  caught  on  the  act  of  falling,  much  the 
same  as  water  is  caught,  and  held  in  the  formation  of  an  icicle. 

"The  duration  of  time  in  which  the  metal  is  transformed 
from  a  molten  to  a  solid  state  is  exceedingly  short,  and  the  fact 
that  the  metal  retains  enough  heat  to  maintain  a  red  color  for 
a  time,  furnishes  no  scientific  proof  that  the  metal  in  the  mold 
will  shrink  for  flic  metal  that  remains  in  the  criicihle  aucl  the 
iiK'fat  ui  the  mold  encounter  conditions  in  hardening  which  are 
(lid metrically  opposed.  The  metal  in  the  crucil)le  is  confined  by 
no  walls,  and  the  pressure  on  it  ])eing  from  without  inward,  has 
no  such  effect,  as  on  that  confined  in  the  mold,  for  the  reason 
that  the  hydraulic  ])ressure  that  the  confined  gold  is  subjectcyd 
to,  forces  the  inetal  froin  the  ceiitei',  outwardly  as  long  as  it 
remains  molten,  and  thus  it  is  pressed  against  the  cooler  walls 
wliei-e  the  crust  as  described  is  formed,  and  which  will  register 
a  density  of  19.45  against  19. Hi  of  tiiat  i-emaining  in  the  crucible; 
and  there  is  no  inherent  I'oi'ce  or  physical  ])roi)er1_\-  in  the  nietal 
itself  after  being  cast  und<'r  pivssure  capable  of  suggesting  its 
density  to  any  fui'ther <legi(M'. 

"So  it  is  physically  imjjossible  for  it  to  shrink  to  any  a2)pre- 


CAST!X(J    MOL'I'KX     .MKTAL .MACIIINKS    I'.M  I'l.O VKD  IDT 

ciablc  degree,  Uici-crofc,  if,  in  llic  process  of  iiiakiii;;-  an  inlay 
()i-  a  more  extended  j)ie('e  by  casting'  under  jjressuiv,  any  dis- 
tortion occurs,  or  it  is  not  a  facsimile  of  the  wax  model,  the  dis- 
ci-e])ancy  must  be  ascribed  to  some  other  factor  or  cause  than 
the  shi'inking  of  the  gohl  ah)ne. 

"  If  this  ,i;h)bule  of  gold  were  measured  for  its  specific  grav- 
ity, it  would  be  found  that  it  developed  hy  the  mutual  attrac- 
tion of  its  molecules  (cohesion),  a  density  that  registers  a 
relative  specific  gravity  of  19.16. 

"Thus,  if  gold,  heated  so  as  to  assume  the  liquid  state,  be 
allowed  to  congeal  uninfluenced  by  any  interfering  conditions, 
the  only  factors  entering  into  the  phenomena  being  mass,  co- 
hesion, heat,  molecular  mobility,  volume  and  gravitation,  it  is 
a  ])liysical  possibility  for  the  metal  to  develop,  by  virtue  of  its 
cohesive  force,  a  density  that  registers  a  relative  specific  grav- 
ity above  19.1(3.  hi  the  casting  of  metal  under  pressure,  addi- 
tional factors  cuter,  and  must  he  tal^en  iuto  consideration;  they 
are  hydrciuUc  pressure  and  iveldluf/,  ttir  Jailer  hehuj  Induced  hij 
the  force  of  hydraulic  pressure. 

"If  a  mold  has  been  prepared  in  the  usual  procedure  for 
a  cast  under  jiressure,  and  is  in  a  condition  for  the  reception  of 
the  molten  metal,  a  button  of  gold  fused  in  the  crucible  mani~ 
tests  the  same  physical  phenomena  previously  described.  The 
atoms  will  revolve  around  their  common  centor  more  rapidly 
than  at  a  lower  temperature,  and  the  molecules  will  revolve 
around  each  other  in  like  manner,  and  the  metal  is  gradually 
transformed  from  the  solid  to  the  molten  or  the  liquid  state. 
If  force  now  ])e  suddenly  applied  to  the  liquid  mass  in  the  cru- 
cible, a  portion  of  it  will  be  forced  by  displacement  into  the 
mold,  and  if  the  pressure  be  maintained  for  a  time  it  will  be 
transmitted  from  molecule  to  molecule,  simultaneously  iu  every 
conceivable  direction,  the  hj^draulic  force  pressing  the  mole- 
cules to  all  surfaces  and  angles  of  the  mold.  As  the  molecules 
at  tlie  surface  of  the  mass  come  in  sudden  contact  with  the  walls 
of  the  mold,  their  movements  are  abruptly  checked,  the  atoms 
of  the  molecules  are  forced  to  closer  proximity,  the  molecules 
decrease  in  volume  and  have  less  latitude  in  which  to  exercise 
their  mobility,  Avhich  instantly  induces  congtalation;  and  as  they 
are  held  hrnilv  against  the  walls  of  the  mold,  gaps  and  crevices 


198  CAST    COIJ)    AXD    I'OIH'KI.AIX     INl.AVS 

occur,  wliicli  arc.  liowcx cr,  lillcd  1»\'  the  ])i-cssurc  l)cliiiRl,  and 
with  iiic()iicci\"al)lc  I'apidity,  w  itli  new  r( cruits,  frenzied  and 
licat  maddened,  wliere  tlie\'  meet  the  same  fate  as  tlieir  fellows, 
crnslied  antl  jammed  ai;ainst  eacli  other  and  tlie  walls  of  the 
mold  nntii  in  congeal in.i;'  a  rigid  wall  or  cajisnle  lines  every  sur- 
face and  angle  of  the  moKl. 

"This  goes  on  in  the  same  way  nntil  the  sui'l'ace  crust  thick- 
ens to  the  center,  all  following  the  same  reguhir  order  of  things, 
but  with  no  loss  of  apjjreciable  time  in  a  small  mass  of  gold  as 
niignt  be  inferred  from  the  deliberate  description.  This  metal 
will  be  found  to  l)e  of  higher  specific  gravity  than  when  it  is 
allowed  to  cool  under  ordinary  conditions." 

Here  then  we  have  a  quotation  from  a  treatise  written  by 
one  who  used  as  a  guide  and  reference  nearly  every  known  au- 
tlioi'ity  on  the  subject,  and  here  too,  we  lind  as  a  result  of  his 
incpiest  into  the  mystery,  the  definite  statement  that  in  casting- 
gold  under  pressure  the  part  entering  the  mold  is  the  first  to 
congeal.  A  statement  which  not  only  emphatically  but  most 
effectually  contradicts  the  assertion  of  an  extoUer  of  the  virtues 
of  the  \acunni  ])rocess,  that  only  with  this  machine  does  the 
hardening  of  the  mass  in  the  inold  take  place  before  the  harden- 
ing of  the  mass  in  the  crucible. 

As  a  matter  of  fact,  in  all  casting  of  high-fusing  metal,  with 
tlie  aid  of  any  j^i'^'-'^f^ure  exerted  upon  the  molten  mass  by  anj^ 
special  apparatus,  the  surplus  in  the  crucible  is  the  very  last 
to  congeal  or  crystallize,  and  that  part  entering  the  mold  is  the 
iii'st  to  assume  an  unalterable  shape. 

Since  the  invention  of  ])ressure  casting  as  apjolicd  to  den- 
tist i'\-,  doz'Mis  of  ])i-essure  casting  machines  have  been  offered 
to  the  profes.-ioii  and  each  one  was,  accoi-ding  to  the  lit(  I'atni-e 
of  the  niak'er,  llie  hcst  for  the  purpose.  Thei-e  is  the  LeCrone, 
the  Cleveland  l)<  ntal.  the  sim|)le  little  swage,  the  Sure  Cast, 
the  Sim})hx,  the  Seymour,  in  fact  tiiere  ai-e  so  many,  that  the 
numlter  would  comj)ai'e  fa\()ial)l\'  with  the  nuniher  of  dilTei-ent 
makes  of  automobiles,  and  lik'c  automobiles,  they  would  all  go 
for  a  time,  and  al'ler  a  fashion.  All  can  ])ui'[  nud  snort,  and 
make  a  noise.  Tli<-  point  of  intei-est  to  the  ])rofession  is,  that 
these  machines  iihinialel>-  dilTcr  widel>-  in  the  i-csult  that  one 
can  accomplish   wit  h  1  hem. 


CASTixc;   .Moi/i'KX   .Mirr.M.  —  .MAciiiXKs  ^;.MIM,()^•|■;l)  ID!) 

Some  of  the  pressure  iiiacliiiies  iiieiil  ioiied  >iil»|)l\'  tlie  nec- 
essary toi-ce  hy  IVediii*;- conijji-essed  air  tliroii^li  a  cliamlx'r  wliicli 
opens  onto  and  above  Die  molten  mass;  otiiei's  simj)ly  allow  a 
little  ('liam))er  filled  with  a  moist  (•om])i'essi])le  substance  to  be 
placed  ()\-ei'  tile  ci'ucible  wliicli  coiitaiiie(l  the  molten  metal,  the 
heat  of  this  metal,  acting'  ii])on  the  moistuic  contained  in  the 
al)ove  substance  would  convert  tliis  moistui'e  into  steam,  and 
this  steam  would  supply  the  ])r(  ssure  necessary  to  i)i"0i)el  the 
metal  into  the  mold. 

'file  most  I'eliable  of  these  is  one  called  the  Soll)ri<;'  machine 
and  is  mai'keted  liei'e  by  Ash  &  Sons.  AVcre  this  machine  sup- 
])lied  with  a  means  for  definitely  controllinf;'  and  measuring  the 
pressure,  it  would  j)rove  a  valuable  appliance  in  one's  labora- 
tory, and  he  ({uite  suitable  for  inlay  work.  As  it  stands  today, 
it  may  he  nsed  only  for  castiufj,'  that  requires  no  delinition  of 
tine  lines,  an<i,-les,  or  margins,  where  microscoi)ic  accuracy  in 
reproduction  of  those  lines,  angles,  and  margins  is  not  an  essen- 
tial factor.  I  know  of  no  inlay  that  will  permit  of  such  devia- 
tion, and  still  he  tit  for  use  for  any  cavity  in  any  tooth,  A  Inief 
description  of  this  machine  will  suffice.  , 

It  consists  of  the  hase,  ujjon  which  the  llask  containing  the 
mold  rests.  This  flask  is  received  in  a  shallow  ring  upon  the 
hase.  A  rigid  support  rises  from  the  hase,  and  to  this  su2)port 
a  m<)val)le  arm  carrying  an  adjustahle  metal  cover,  is  connected. 
This  adjustahle  metal  cover  tits  loosely  over  the  flask.  "When 
the  wax  pattern  has  heen  hurned  out  of  the  mold,  the  Hask  is 
placed  into  the  ring  upon  the  hase,  and  an  ashestos  disc,  satu- 
rated with  water,  is  j^tlaced  into  the  cover.  The  gold  is  })nt  into 
the  crucible  in  the  mold,  and  is  brought  to  a  hoiling  point;  the 
movahle  arm,  carrying  the  adjustahle  cover  is  brought  down- 
ward onto  the  flask  containing  the  molten  metal,  and  held  there 
for  a  minute,  when  the  casting  is  comi)leted.  The  heat  of  the 
metal  converts  the  water  in  the  asbestos  disc  into  steam,  and 
this  steam,  confined  in  the  small  area,  induces  a  tremendous 
pressure  ui:)on  the  molten  mass;  just  what  effect  all  this  pres- 
sure may  have  on  this  mold  is  a  matter  which  may  be  calculated 
by  taking  the  resistance  and  the  amount  of  the  pressure  under 
consideration.  Absolutely  delinite  results  are  impossible  Avitli 
this  machine  l)ecause  the  ])ressure  is  uncontrolled  and  can  not 


1*00  LAST    GOLD    AND    POllClil.AI  N     INLAYS 

be  (letiiLitely  and  ineasural)ly  modified.  AVe  do  not  need  a  ton 
of  dynamite  to  blast  a  pebble  out  of  tlie  sandy  beacb. 

The  machine  I  use  for  the  casting  of  gold  inlays  is  a  direct 
l^ressure  machine,  invented  and  Iniilt  for  this  jDurpose  by  the 
inventor  of  the  x>i'ocess.  It  is  a  machine  which  enables  one  to 
bring  the  gold  to  a  boiling  point  in  the  crucible  of  the  flask 
before  the  entire  mold  has  been  heated  to  a  point  of  distortion. 
It  makes  possible  the  use  of  a  small  nitrous  oxide  flame,  and  it 
gives  off  an  infinitely  greater  amount  of  heat  concentrated  on 
the  bottom  of  the  metal,  than  can  be  obtained  with  a  large  blast 
fiame  of  the  ordinary  blowpipe.  It  is  a  machine  which  enables 
a  man  to  apply  a  measured  amount  of  perfectly  sustained  pres- 
sure at  the  very  luoment  when  he  realizes  that  he  must  have 
this  pressure,  and  the  fiame  is  automatically  turned  off.  as  the 
pressure  is  applied. 

I  use  this  machine  in  conjunction  with  the  entire  technic, 
hf'cause  it  enales  me  to  do  my  jvork  of  restoration  in  such  a. 
iHcnnier  as  to  maJxP  the  pr  oh  ability  of  recurrent  requirement  for 
finiJicr  rtl'crf  'ni  that  direction  very  remote,  if  not  altogther 
impossible. 

This  is  what  the  cast  gold  inlay,  conceived  and  made  avail- 
able for  i3ublic  use  by  the  discoverer,  Avill  do,  if  we  are  careful 
to  follow  the  directions  in  every  step  of  the  procedure. 

It  is  essential  for  him  who  would  practice  gold  inlay  work 
correctly  to  consider  the  entire  technic  as  a  complete  circum- 
ference of  a  circle,  presenting  no  break  in  its  continuity.  In  the 
center  of  that  circle  and  responsible  for  this  unbroken  circum- 
ference is  the  ideal  which  the  inventor  conceived  and  held  onto 
while  he  thoroKyhly  and  carefully  worked  out  every  phase  of 
tills  technic. 

TIk'I-c  can  !»<■  no  (lucslioii  iij)()ii  Ibc  statement  that  all  of 
tlii>  icvolutionizing  ])rincipl('  had  its  iiiccjttion  in,  first,  a  vivid 
lealization  that  present  iiictliods  wciv  iiiclficient  to  stem  the 
tide  of  tooth  destruction;  and,  second,  in  the  birth  of  the  ideal 
of  what  should  be  done  in  ordei-  to  effectually  stem  this  tide. 
If  we  place  this  ideal  in  the  center  of  this  circle,  and  now  divide 
our  circumference  into  its  360  degrees,  and  run  a  radius  from 
each  degree  u|)on  the  cii-cumference  to  the  centei-,  we  shall  be 
in   a   bettei-  ])0>ition    to   understand   just    Ik.w   closely  (le|)en(lent 


CASTIXC    IMOI/l'KX     .MIITAF. —  MACHIXKS    K.MIM-()^'KI) 


201 


upon    this    ('()iic('i\<Ml    ideal    lias    heeii    and    must    he    the    ciitii'O 
tccliiiic. 

Indeed,  with  the  ideal  already  fixed  in  the  mind  of  the  in- 
ventor, it  hecaiiie  only  a  f|iiestion  of  time  as  to  when  the  enor- 
mous amount  of  mental  activity  ])layin<i-  around  tliis  ideal,  woidd 
manifest  itself  in  the  expenditure  of  pliysieal  elToii  which  wouhl 


Fig.  171. — Taggart  macliiiic  with  fla.sk  in  position  on  its  base.  Cliarcoal 
block  and  nitrous  oxide  flame  playing  upon  a  button  of  gold.  To  the  right  is  a 
large  box  containing  a  mixture  of  jiotassium  nitrate  and  ])orax.  The  gauge  upon 
the  Taggart  machine  indicates  five  pounds  of  pressure. 


in  time  create  in  actual  ])hysical  rorm  wliat  already  existed  in 
the  ahstraot,  hut,  nevertheless,  causative,  ideal  of  it.  And  so 
this  ideal,  ))owei-ful,  i;i-eat  and  l)eneliceiit,  and  with  tlie  a]J])roval 
of  all  cosmic  laws  to  aid  it,  occupies  tlie  central  thi'one  and  he- 
gins   to   throw    out    its   elements   of  physical  manifestation    as 


'2{y2 


CAST    (,;OLI)    AXl)    roltt'KLAlX    JXLAVS 


radii  of  a  ciiTlo.  Oik*  cleiiu'iit  is  tlic  wax,  and  we  see  tills  gTow 
from  an  obscnro  indclinilc  ]M)int  to  a  (dearly  determined  actual- 
ity; anollu'r  olcnn  nt  is  tlic  ('oni])ound,  ft'oing-  tlirouf!,'li  the  same 


Fig.  172. — The  Taf^gart:  inacliiiie  laisnl  in  ycvM]\i  ilic  use  of  a  miiiiljcr  of 
.sizes  of  larger  fla.sks  (lesigncd  liy  tlic  autlinr  lo  cuaMi'  hiin  to  make  larger  ca.stiiigs 
for  extensive  cases  of  restoration  jcijiiirinn  large  saihllis  for  reiiiovublc  bridge 
dentures. 


cycle  of  cxjK'ricncc;  llicii  caiiic  (lie  criiciMc,  lis  dcplii,  ils  widtli, 
and  cnrvatiire  of  lis  ;irc,  aii:l  llic  I'darioii  oF  litis  dcplli  <o  lliis 
widtli  and  curNc,  aitd  the  sprue,  lite  leii.utit  of  lltal  and  lite  re- 


CAS'I'IXC     MOI/i'KX     Ml'/FAL .MACIIIXKS    K  M  IM.OVKD  I'D.) 

lalioi!  of  llic  IciiLvtli  ol'  Dial  to  the  |);i11<'ni  witliiii  llic  mold;  and 
the  llask%  llic  liciidd  ;iiid  the  widlli  and  tli"  circiiinrcrciKM'  of 
thai;  and  llic  rclnlion  of  llicsc  lo  tli'  {'urxc  and  the  dcplli  and 
width  of  the  ciucililc  ;iti(l  ihc  pattern  within  the  mold;  the  mixer 
and  tli:'  licatci';  the  hlowpipe  and  the  mixini;'  ('liamhei-  I'oi'  the 
^■as(  s;  the  i'e,i;n latin";  of  the  pfcssure  as  to  inci'case  and  de- 
crease, and  the  snstainin^-  ol'  the  pi-essnrc  tlins  olttained;  and 
tlic  inacliinc  as  a  whole. 

'^riie  hnndi-cds  npoii  hundi'cds  of  (pu  stions  w  liicli  wtM'O 
found  and  had  to  he  solNcd,  and  were  soi\'ed,  not  onlx'  as  indi- 
vidual ])i'ol)lems,  hut  as  jji-ohh  ms  i-elatcd  eacli  to  tlie  otlier  wliich 
came  h'd'ore,  and  the  oik  whicli  was  to  follow;  so  this  worlv 
went  on  until  this  ideal,  sittin.i!,-,  so  to  speak,  in  the  centei'  of  our 
abstract  circle,  Jiad  sent  out  tliesc^  radii  toward  every  de^'ree 
u])on  tli(^  cii-eund'ereuc!',  and  l)eliohlI  tlie  task  Avas  couiplete. 
Here  is  a  ])r()cess  so  ixM'I'ect  tliat  not  a  weak  point  can  l)e  fouud 
in  it,  and  hei'c  too,  is  a  inacliine  so  ])ert'ect,  and  accessories  so 
uni(pu',  tluit  all  interplayed  perfectly  witli  cacli  otlier  to  call 
forth  a  i)erfe:'t  result,  ])rovided  all  of  it,  tln^  process,  the  lua- 
cliine,  and  the  accessories,  are  well  understood  and  properly 
handled. 

Jt  is  not  to  ])e  marveled  at  that  the  idea  of  cast  ^old  inlays 
swe])t  the  profession  chnm  off  its  feet  into  a  frenzy  of  hopeful 
enthusiasm.  llei-e  at  last  was  the  possi))ility  of  doin"-  the  rig'ht 
kind  of  restorative  woi'k,  and  ])lind  indeed  Ave  should  have  been 
had  we  failed  to  recognize  it.  Here  were  possil)ilities  so  pre^-- 
nant  with  hope  for  the  betterment  of  the  race,  dentally  con- 
sidered, so  potent  in  effect  u])on  the  future  of  their  well  bein"- 
that  it  seemed  as  if  the  ft'lory  of  truth  liad  at  last  broken  tlirou<;h 
the  meshwork  of  inefficient  and  often  misleading  dogma. 

The  jn'ofession  saw  it  and  ,i;as})ed  at  the  one  stu])endous 
stride  that  would  make  creators  out  of  them  in  place  of 
menders. 

They  who  followed  im]jlicitly  all  the  directions,  l)ent  every 
effort  to  carry  out  minutely  every  d(>tail  of  the  technic,  who 
studied  and  understood  the  machine  by  itself,  and  in  relation 
to  every  step  Avhich  accompanies  the  us(>  ol"  all  the  carefully 
"[)lanned  accessoi'ies,  have  ])een  rewarded  beyond  their  own 
hoi)es  and  dreams.     They  have  seen  a  new  era  rise  in  dental 


204 


CAST    COr.D    AXD    TOIU'KLAIX    IX'T.AVS 


service  and  dental  acconiplislinient,  and  Avilli  the  nso  of  the 
process,  their  love  for  tlie  work  lias  o-rown  and  with  tlie  ^rowtli 
of  their  love  foi-  the  work,  tlie  standard  of  their  work  has  heen 
raised.  Dentist i-y  to  tlieiii  is  no  more  a  niei-e  jjrofession,  a 
trade,  a  means  of  a  livelihood.  It  is  a  reli<;ion  to  be  cherished 
and  throu^'hly  studied  for  the  f^ood  it  will  l)ring  to  hnmanity; 
for  the  aid  it  will  hrinf;-  to  strng'glin,i;'  man,  in  his  efforts  to 
evolve  into  a  ])erfeet  l)ein<;-.  That  is  what  dentistry  means  to 
them;  not  one  of  them  hnt  will  affirm  and  add  to  this  declaration. 


Fig.  173. — To  the  right  is  a  vio\v  of  a  small  Taggart  flask  and  its  crucible 
former  Avhich  holds  the  sprue  wire.  To  the  left  is  the  author's  barrel-shaped  flask 
and  its  crucible  former  and  the  shortened  sprue  wire.  The  amount  of  refractory 
compound  surrounding  the  wax  pattern  is  more  nearly  equal  in  bulk  in  all  direc- 
tions in  the  barrel-shaped  flask. 


Fig.  174. — A  special  flask,  l)unid-sliai)ed,  made  Ity  the  author  in  two  sections 
to  be  used  for  large  castings.  The  Taggart  machine  that  takes  this  flask  has  been 
rai.scd  from  its  platform  sufficient!}'  to  provide  the  necessary  room. 


Is  not  such  an  experience  an  inccntixc  to  e\'ei-y  student, 
and  every  dentist  who  has  not  >(  t  ddiie  so,  to  tak'e  u])  this 
])rocess  and  study  it,  and  |)ei'severe  and  follow  insti'uctions  until 
it  lias  lieeii  niastei'e(|  .' 

The  use  of  this  iinichiiic  is  e.\cee(lin,i;l\-  siiii|»l('.  it  is  a  (|ues- 
tion  of  knowing  what  is  wanted,  of  k'nowing  that  the  machine 
will  do  all  it  is  int<'nde(l  foi",  and  of  testing  the  machine  hefoi'c 
each  casting;'  to  iiiak'e  sure  that  all  is  in  order. 


CASTixd   .M()i;rK.\    .mktai. — mac  ii  inks  km  i'L()\i:i)  I'D") 

rpoii  cxaiiiiiialioii  of  tlic  llasks  designed  l)y  Dr.  'ra^*;art, 
i1  will  he  noticed  that  cacli  one  contains  a  small  lioh^  about  the 
size  ol'  ll-^an,H('  wiic.  '^I'lii.s  serves  two  pui-poses;  it  forms  a 
vent  to  i'acilitatc  the  ('sca]ie  of  any  ,i;as  oi-  air  wliicli  may  bo 
present  at  the  time  of  castiii.ii,',  and  wliicli  mi.^lit  offei-  a  resist- 
ance to  the  ingress  of  the  metal;  and  it  serves  to  show  liow 
well  or  how  ])oorly  the  ])ressure  ft'as  may  l)e  flowing-  tiiroiift'h 
tlie  vertical  cylinder  into  the  pressure  2)late,  and  from  there 
onto  t  he  metal. 

Test  the  machine  out  as  follows: 

Place  a  piece  of  ru])ber  dam  into  tlie  small  l)ase  of  the  nia- 
cin ne,  and  seat  the  ilask  roundside  up  into  this  base;  open  the 
valve  on  tlie  nitrous  oxide  cylinder,  and  by  means  of  tlie  reduc- 
ing valve,  regulate  the  pressure  to  the  desired  point.  (Three 
to  five  pounds  pressure  is  the  right  amount  for  casting  inlays.) 

See  that  the  packing  in  the  pressure  head  is  not  dried  out 
and  leaky,  and  see  that  the  four  snudl  lioles  wdncli  allow  the 
gas  to  pass  through  down  onto  the  flask,  are  free  from  any 
metal  or  other  ol)struction. 

Xow  bring  the  arm  or  lever  of  the  machine  forward  down 
upon  the  flask  while  you  hold  the  fingers  of  the  other  hand 
around  the  flask  so  as  to  close  the  hole  at  the  upper  -psivt  of  it. 

The  bringing  forward  and  downward  of  the  lever  will  throw 
a  valve  inside  of  the  vertical  cylinder  which  Avill  cause  the 
nitrons  oxide  to  descend  through  it.  If  you  feel  tlie  pressure  of 
the  descending  gas  upon  your  finger,  which  closes  the  hole  in 
the  flask,  the  machine  is  in  good  shape  and  fit  to  be  cast  with. 
Now  alternately  remove  and  replace  your  finger  over  the  flask 
opening;  the  hand  upon  the  pressure  gauge  should  kee]i  time 
with  your  actions,  that  is,  it  should  drop  to  zero  as  you  remove 
your  finger,  and  reascend  to  three  or  five  pounds  as  you  close 
the  opening. 

This  will  sliow  the  i^erfect  condition  of  the  machine,  and 
you  may  reh'  upon  it  for  the  sustained  pressure  rec[uired  for 
successful  casting. 

Now  release  the  lever  arm  and  remove  the  empty  flask,  sub- 
stituting for  it  the  flask  containing  the  mold  ready  for  casting. 
Turn  the  blowpipe  until  it  is  at  right  angles  to  the  machine,  and 
ignite  the  city  gas,  opening  the  city  gas  valve  until  you  have  a 


200  CA;^T    C.OT.D    AXD    TOIU'ELATX    IXfAYS 

llaiiK^  alioiit  Fdur  iiu-lu's  loiii;-.  X()\\'  place  a  hiitloii  of  clean  gold 
1'4  carat  line  (be  sure  it  is  clraii)  into  a  charcoal  cnicible  placed 
near  the  flask  (])ut  on  hrown  or  l)lne  glasses)  and  open  tlie 
needle  vahe  on  the  regnlatoi',  which  will  aHow  the  nitrons  oxide 
to  How  into  the  mixing  chamber,  throngli  which  the  city  gas  is 
(lowing.  Tile  mixing  of  the  two  gases  will  produce  a  very  hot 
bine  llame  abont  three-quarters  of  an  inch  long,  and  this  flame 
is  directed  n])()n  the  button  of  gold  l)y  Inrning  tlie  ])l()W])i2)e 
(h)wnward  directly  over  it. 

In  about  thirty  to  sixty  seconds,  varying  with  the  amount 
of  gold,  the  flame  will  have  brought  the  metal  almost  to  the 
fusing  point,  liemove  the  heated  gold  to  the  crucible  in  the 
flask  and  play  the  flame  upon  it.  The  tendency  of  the  mass  to 
assume  a  sjnieroidal  shape  will  now  a^jpear,  and  finally  the 
molten  metal  will  ])resent  a  glowing  shape  and  the  mass  Avill 
])e  seen  to  move.  The  gold  may  now  be  called  fluid,  but  it  is 
not  yet  hot  enough  for  casting.  If  it  were  cast  at  this  moment 
a  vei-y  sluggish  mass  Avould  have  to  1)e  dealt  with,  and  a  very 
im]ierfect  ])iece  of  work  would  he  the  result. 

This  may  be  avoided  by  keeping  the  llame  u])on  the  fluid 
gold  nntil  the  heat  of  it  has  been  raised  to  such  a  point  that 
the  iiK^lecuh  s  seem  to  repel  one  another  violently.  The  molten 
mass  will  assume  Hk'  color  of  sunlight,  with  a  violet  tint  in  it, 
the  mass  will  not  move  from  side  to  side  but  will  rise  in  the 
crucible,  as  if  i)uslied  uj)  from  beneath,  only  to  di-oj)  back  again 
to  repeat  the  performance. 

All  this  has  taken  less  than  a  minute  and  at  this  stage  the 
level-  is  bi-onghl  smartly  forward;  the  ])luiiger  and  ])ressure 
heads  descend  n])on  the  Hash,  the  blow])i])e  is  thrown  to  one 
side,  the  city  gas  is  slint  off,  the  \al\-e  which  allows  the  ])ressure 
gas  to  ■descend  ii|ioii  th<'  molten  metal  is  thrown  open,  as  the 
fhisk  is  sealed,  and  the  molten  metal  is  foi'ced  into  the  mold  and 
lield  there  under  a  constant  and  snstained  ])ressnre. 

The  nitrons  oxide,  ])revionsly  usecl  to  aid  in  melting  the 
metal,  backs  up  and  reenters  the  (hscending  xaKc  to  sjxMid  its 
force  or  ])ressure  upon  the  congealing  mass. 

It  is  unnecessary  to  again  enuinei-ate  all  the  curious  molec- 
ular movenif  Ills  and  atomic  agitations  which  tak'e  ])lace  on  cast- 
illii'.       At     best,     tliev     ;ire     1lie()fe1ic     consideration,     be;int  ifnlK' 


CASTIXCi    -MOI/rKX     MKT.M.  M  \('ll  IXKS    K.M  I'l .( )^■KI »  207 

I'cnsoiK'd  oiil  ;  Iml  for  the  iiinii  <l()iii,i;'  llic  pi'.-id  leal  work  as  out- 
liiicil  liciciii,  tlicy  need  caii'N'  no  riirllicr  iiii|M)r1aii(M',  cxccj)!  {o 
Inroi-iii  liiiii  (»r  what  acliiaMx'  takes  place. 

I^'foiii  foi'tN  seconds  to  a  I'lill  iiiiiiiite's  lime  sliould  1)0  fj,-ivon 
foi-  the  .-^as  to  exercis;'  its  ])ressui-(  a.^aiiist  llic  coii«iealing  metal. 
The  h'\-er  iiia\'  then  he  i-eiease(l  hy  |)ullin:;'  tli(*  sprin^i'-actuatcil 
])iii  on  the  ui)|)ei'  part  of  the  niachinedn  ad  t'oi-ward.  'I'lie  lever 
is  then  Ihiowii  hack,  and  will  can\  the  ))ressui-e  head  ujjward. 
The  Mask'  will,  in  ino>t  instances,  he  round  cool  eiioiifi'li  to  grasp 
witli  tlie  liaiid,  ilhist  rat  in,u'  how  little  actual  and  distorting  heat 
entered  tin    mold  during;'  the  uieitinL;'  of  the  metal. 

if  he  llask  h;'  uncomfoitahly  warm,  it  may  be  grasped  Avitli 
llie  thisk  r()rce])s,  and  eilliei-  thi-own  into  a  howl  of  water,  or  held 
under  the  cold  water  faucet,  until  the  mold  disintegrates  and 
is  washed  off.  A  stiff  toothl)rusli  will  remove  most  of  the  com- 
])Ound  around  the  iiday  and  sui-plus,  and  we  sliall  liiid  the  cast- 
ing conii)lete. 


EEFEEEXCE  CONSULTED  OX  THE  EXPAX8I0X  AXD  COXTRACTIOX 

OF  METALS 

Clark,  D.  K.:     A  ]\ramial   of  Eulcs,  Tables  and  Data   for  Mcflianieal  Engineers, 

187S,   *K598. 
Dana,  E.  S.:     Editorial,  Am.  .Jour.  Sc.  and  Arts,  1901,  vol.  clxi. 
DuBois,  A.  J.:     Elementary  Principles  of  Mechanics,  1894,  vol.  ii,  K4982.2. 
Howe,  H.  M.:     Metallurgical  Laboratory  Notes,  1902,  K127S0. 
Hutton,  W.  S.:     Practical  Engineer's  Handbook,  1896,  K5405. 
Lineham,  W.  J.:     Text-book  of  Mechanical  Engineering,  1894,  K4958. 
Poynting,  J.  IL,  and  Tlionip>()n,  .T.  J.:      Text-book  of  Physics,  1904,  K15930.3. 
Eankine,  W.  J.  M.:     Manual  of  Civil  Engineering,  1891,  K661. 
Thurston,  E.  H. :      Brasses,  Bronzes,  and  Other  Alloys,  1900,  K5.j02..3. 
Useful  Eules  and  Tables,  1873,  K665. 
Watson,  W.:      Text-book   of  Physics.   100.3.  K1.5933. 


SUMMARY  FOE,  CHAPTER  XIV 

The  Casting  of  the  Molten  Metal  Into  the  Mold 

1.  Describe  the  part  jilayiMl  by  temperature  in  tlie  inlay  technic  up  to  the  point 
of  drying  out. 

2.  AVhat  happens  when   the  .flask  is  heated  ?     What  effect  on  the  mold  has 
the  proximity  of  the  flask  to  it? 

3.  What  is  the  result  of  casting  into  a  hot  mohl  ? 

4.  Why    is    a    coid    flask    necessary    and    how    does    it    follow    the    temperature 
sequence? 


2()S  CAST    COl.D    A>;i)    roitCLvLAlN    ]NLAVS 

The  Casting  of  Metal  into  the  Mold  and  a  Consideration  of  the  Various  Machines 

Employed 

1.  What   is   the   principal   objection   to    the   nsc   of   a    casting   appliance    in- 
volving centrifugal  force? 

2.  Give  the  reasons  for  and  against  the  choice  of  a  vacuum  machine. 

3.  "What  are  the  essentials  of  a  casting  machine  involving  direct  pressure? 

4.  How    would    you    prevent    the    distortion    of    the    mold    during    the    actual 
casting  .of  the  inlay? 

5.  Describe  the  technic  of  casting  in  a  Taggart  machine. 


C'HAPTEK  XV 

TIIH  CLEANSING  OF  THE  CASTING  IN  HYDRO- 

FIJ  OlMC  ACID  AND  IN  A  SODIU:\[ 

]U(\VKP>ONATE  BATH 

After  the  casting;'  has  ))oeii  carefully  and  thoroughly  brushed 
free  from  compound,  it  is  placed  in  a  rubber  cup  containino- 
hydrofluoric  acid.  The  acid  will  free  the  casting  from  any  of 
the  silicate  it  may  still  have  on  it.  It  would  be  impossible 
to  remove  every  evidence  of  this  by  the  use  of  the  brush  only. 
Owing  to  the  enormous  amount  of  heat  to  which  the  metal  is 
subjected  under  the  nitrous  oxide  flame,  it  picks  up  a  number 
of  mineral  and  metallic  impurities,  which,  however,  are  finally 
forced  to  the  surface  of  the  casting  and  the  crucible  side  of  the 
surplus.  Particularly  does  the  crucible  side  of  the  surplus  but- 
ton become  contaminated  with  interfering  agents  which  it  j^icks 
up  from  the  silica,  and  for  this  reason  it  is  advisable  (impera- 
tive is  the  word)  not  to  use  any  gold  for  casting  unless  it  is 
al)solutely  clean. 

It  is  best  to  take  these  surplus  l)uttons  and  define  them  be- 
fore using  them  again.    ]\Iore  of  this  later. 

AVhen  the  easting  has  been  in  the  acid  at  least  several  hours 
(it  is  sometimes  best  to  leave  it  in  overnight),  the  cover  is 
removed  from  the  hard  rubber  acid  cup,  and  the  casting  is  taken 
out  with  a  pair  of  tweezers  and  washed,  under  the  faucet,  then 
])ruslied  with  soap  and  watei'. 

A  test  tube  about  six  inches  long  and  three-quarters  of  an 
inch  in  diameter,  is  filled  about  one-third  of  its  capacity  with 
a  saturated  solution  of  sodium  bicarbonate,  and  the  casting  is 
boiled  in  this  solution  until  every  trace  of  the  acid  has  been 
neutralized. 

It  is  important  that  the  acid  be  neutralized  beyond  a  doubt 
because  of  the  deleterious  effect  of  the  least  particle  of  this  acid 
upon  any  cement  or  tooth  structure. 

209 


210 


CAST    (;()IJ»    AND    T()i;('FJ>AIX    IXLAVS 


liu])l)er  and  inclal,  and  tlie  waxes,  seem  to  l)e  tli  eonly  sub- 
stances wliieli  are  not  attacked  l)y  it;  lienee  tlu'  use  of  the  rubber 
eu])  as  a  receptacle  t'oi'  it.  1  l)OU<;lit  a  hard  rubber  cup  about 
four  inches  lii^'h,  two  an<l  one-half  inches  in  diameter  at  the 
mouth,  and  about  one  and  three-fourths  indies  in  diameter  at 
tlK>  bottom.  It  is  an  ordinary  liard  rubber  drinking  cup  and 
may  l)e  bought  at  any  rubber  goods  sliop  or  large  drug  store. 
This  is  used  for  the  hvdrolluoric  acid. 


y\,r,   ]75._Acicl   cup,   support,   ;iiii1    stopper    for   liydrofluoiic   acid,      a,   stopper;    1), 
''"        taporiiij4-  liard    nil.lici-  nip;    r.    paster   of   J'aris   blofk   carryiiij;-   t-ups. 

A  batch  of  i)laster  of  i'aris  was  mixed  to  a  creamy  con- 
sistency and  ])OUi-ed  into  a  papei'  hox  foui"  inches  square.  Into 
this  mix  of  plaster,  llie  nioistenecj  ruhWer  cu))  was  forced  to 
witliin  one-lialf  inch  of  1h<-  hoUoiii  of  the  box  containing  the 
])laster,   and    liie   mass  contiilning  the  cu|)   was  allowed   to  set. 

TUv   nexl    day   Ihc  ])aj)ei'  was  I'eiiioved,  and   the  sui'face  of 


CIJOANSIXC    TIM';    CASTIXC  211 

the  plaslcf  was  t  riiiiiiicd  lo  a  si,i;lill\'  a|)|)(  araiicc  After  scneral 
(lays  the  mass  had  t  lioi-oiii^lily  liardciicd  and  sliniid^  hccause  of 
the  ('()ii('-slia|)!'  of  llic  ('ii|),  and  was  expelled  IVoni  its  seat. 

A  quantity  of  stearine  was  allowed  to  come  to  a  hoi!  in  an 
a<^"ateware  vessel,  and  the  ])lasier  I'oi'ni  was  ])iit  into  it  and  al- 
lowed to  l)()il  t'oi"  one  and  one-liall*  lioui's.  H'lie  I'esult  was  a  ])las- 
ter  receptacle,  liai'd  and  sniootli,  into  wliicli  the  cuj)  could  he 
])laced,  and  which   torni  it  was  i)i'acticaliy  iinpossihle  to  upset. 

Wlu'u  the  cup  was  put  iuto  the  seat,  it  was  tui'iied  toward 
the  ri^ht  aiul  \\as  made  to  lit  \'ery  snugly.  About  oue-thii'd 
of  the  cu])  extends  beyond  aiul  out  of  the  ])laster,  so  that  it  uiay 
be  easily  <;'rasped  and  turned  to  the  lel't  I'oi'  the  ])ur))ose  of 
unseating  it. 

A  block  of  wood  was  sha])ed  to  loosely  lit  the  mouth  of  the 
cu]j,  and  into  the  center  of  this  ))lock  ajid  going  half  way  through 
it,  a  small  brass  eye  was  inserted  to  serve  as  a  handle. 

A  layer  of  pai'affine  about  one-eighth  of  an  inch  was  i3laced 
over  every  part  of  this  block,  and  it  was  again  fitted  into  the 
cup.  AVhile  it  was  sc'atcd,  more  ])araffine  was  added  to  the 
circumference  of  the  l)lock,  and  this  pai-affine  was  allowed  to 
overlap  the  cuji,  thus  producing  a  cover  which  fitted  into  and 
over  the  rul)l)er  container  of  the  deadly  acid. 

Extreme  caution  nmst  be  exercised  in  holding  this  acid, 
and  care  should  be  taken  to  guard  against  the  inhalation  of  its 
irritating  and  deadly  fumes.  The  delet(^rious  effects  from  it 
are  very  lasting,  and  I  have  had  some  decidedly  unpleasant 
experiences  with  it,  to  which  I  would  not  care  to  have  any  of 
my  readers  subjected. 

Into  this  cup  is  poured  one  ounce  of  the  hydrofluoric  acid, 
wdncli  can  be  procured  at  a  chemist's  slioj)  in  four  ounce  wax' 
l)ottles.    The  wax  cork  is  then  sealed  into  the  bottle,  the  bottle 
l)laced  in  a  wooden  box,  and  put  away. 

In  the  average  practice  au  ounce  of  this  acid  will  serve  its 
purpose  for  about  thi-ee  weeks  to  a  month,  when  it  becomes  so 
laden  with  silicates  that  it  may  be  i^ronounccMl  inert  from  cleans- 
ing inlays. 

The  cup  is  then  removed  from  its  seat  in  the  plaster  base 
and  carefully  filled  with  water  Avhich  runs  slowly  out  from  the 
faucet  and  is  allowed  to  overllow  the  cu]i.  ' 


212  CAST    COLD    AXI>    POIU'KLAIX    INLAYS 

This  SO  ^veakolls  tlio  acid  that  it  will  not  hurt  tlie  basin. 
AVlien  tlie  cup  has  been  tliorouglily  cleansed,  it  is  replaced  in 
its  i^laster  seat,  another  ounce  of  the  acid  is  i^oured  into  it  from 
the  acid  bottle,  and  the  cover  is  i)ut  on  as  quickly  as  possible. 

It  is  well  to  take  a  quart  glass  jar,  hll  it  with  water,  and 
put  into  the  water  as  nuich  bicarbonate  of  soda  as  the  water 
will  take  up.  As  required,  the  test  tube  may  be  filled  and  the 
washed  inlays  boiled  in  this  solution  to  completely  neutralize  the 
acid, 

SUMMARY  rOR  CHAPTER  XV 

The  Cleansing  of  the  Casting  in  Hydrofluoric  Acid  and  in  a  Sodium 
Bicarbonate  Bath 

1.  Describe  the  cleansing  of  the  casting  from  impurities  and  give  the  reason 
for  each  step. 

2.  Describe  the  making  of  a  receptacle  for  hydrofluoric  acid. 


CilAPTKIJ  XVL 

BEMOVAL  OK  Til  K  EXCESS  OF  M  KTA L,  Tl IE  POLISHIXC, 
AND  TIIK  CKMENTATIOX  OF  TIIF  IXLAY 

Tlie  .sur])lus  hultoii  is  claiiijxMl  with  a  vise,  and  witli  a  fine 
saw  tiu'  inlay  is  sciiaralcd  I'roni  tlic  excess  l)y  sawin^;'  tliron^li 
the  sprnc,  within  a  miUiiiR'tei'  or  two  of  the  castin*;'.  A  garnet 
])aper  disc,  of  iiii'diuni  grit,  will  remove  the  rest  of  the  sprue, 
and  niediuni-grit  ciittk'  fish  discs  rotated  toward  the  margins 
of  the  inhiy  will  pi'epare  it  for  its  final  ])olisli.  Unless  the  sprue 
Avire  has  been  attaclied  to  any  part  of  the  occhisal  surface,  the 
occlusal  part  of  the  casting  is  not  to  be  touched  witli  stones, 
burrs  or  discs,  and  it  is  not  to  be  touched  at  all  until  the  inlay 
has  l)een  tried  in  the  cavity,  and  the  relative  occlusion  of  it 
determined. 

The  cavo-surfaces  of  the  inlay  are  carcrully  examined  with 
a  magnifying  glass,  and  a  diligent  search  is  instituted  for  any 
irregularities,  such  as  bubbles,  etc.,  which  would,  of  course,  in- 
terfere w'itli  the  proper  seating  of  the  inlay.  If  any  are  found, 
they  may  be  removed  with  a  very  sharj)  sj^oon-sliaped  excavator, 
or  with  a  X"o.  1  or  X^o.  2  round  burr,  held  in  the  handpiece  of  the 
engine.  If  the  area  is  free  from  interference,  the  temjDorary 
stopping  is  removed  from  the  patient's  tooth,  the  cavity  is 
carefully  examined  to  make  certain  that  it  is  absolutely  free 
from  any  obstructions,  and  the  inlay  is  put  into  the  cavity  and 
sent  home  by  tajjping  it  gently,  using  a  stock  of  hard  wood, 
driven  by  a  few"  gentle  taps  from  a  leather-covered  mallet,  Xo 
undue  force  must  be  used;  gentleness  and  perseverance  are  the 
agents  tliat  will  overcome  the  obstacles  usually  encountered  at 
this  stage.  AVhen  the  inlay  has  gone  to  place,  all  margins  are 
carefully  examined,  w  ith  the  aid  of  a  mirror  and  a  fine  exj)lorer. 
If  found  satisfactory,  the  mirror  and  explorer  are  laid  aside, 
and  while  the  fingers  of  one  hand  hold  the  inlay  in  position, 
the  other  hand  manipulates  the  right,  left,  and  straight,  as  well 
as  round  ])urnishers,  always  in  the  direction  with  the  margins. 

213 


I'l-i  CAST    (lOLl)    AND    roitCELAlX    INLAYS 

If  the  directioiis  liave  ))eeii  followed,  practically  no  bur- 
iiisliiiig-  should  he  re({uired,  at  least  not  what  is  generally  under- 
stood as  burnishing. 

There  is  no  occasion  I'oi'  spinning  the  gold,  and  the  use  of 
the  l)urnishers  is  indulged  in  at  the  margins  only  to  ol)viate  the 
necessity  for  discs  at  these  ])(nnts.  ])iscs  sometimes  slip  and  get 
beyond  one's  control  Tor  a  long  enough  time  to  mar  the  perfec- 
tion of  a  piece. 

Jf  the  inlay  proves  difficult  to  seat,  it  should  he  removed 
and  again  scrutinized  with  the  magnifying  glass  for  any  ir- 
regularities or  overhanging  ledges.  These  removed,  the  inlay 
is  again  seated,  and  the  process  of  gently  taj)ping  it  is  repeated. 
Because  these  inlays  fit  so  closely,  and  frictionally  engage  the 
different  walls  of  the  cavity  so  thoroughly,  we  are  sometimes 
compelled  to  seat  and  reseat  them  several  times  before  cemen- 
tation. 

The  burnishers  nmst  not  be  allowed  to  slip  off  the  gold, 
onto  the  tooth;  the  object  is  ]-ather  to  run  the  l)urnisliers  ver- 
tically over  the  inlay  margins,  when  these  are  vertical,  and 
horizontally  over  them,  Avhen  they  are  occlusal  or  cervical;  in 
other  woi'ds,  when  the  margins  run  horizontally  across  the 
tooth. 

With  the  shar])  jjoint  of  a  i^encil  a  line  is  drawn  across 
the  heaviest  i)art  of  the  inlay,  and  this  line  is  continued  over 
the  tooth. 

The  inlay  is  removed  from  the  mouth.  AVitli  a  No.  2  round 
burr  a  recess  is  di-illcd  on  each  side  of  it,  as  near  the  mai'gin 
as  the  enamel  line  will  pei-niit,  and  with  a  ])urr  of  the  same 
size  a  similar  recess  is  drilled  in  the  tooth.  This  procedure 
gives  a  saucer-shaped,  oi-  rather  seniiciicnlar  depi'ession,  on 
the  opposing  mai-gin  of  the  inla\',  and  a  con-esponding  dej)res- 
sion  in  the  tooth.  The  p<  ii"il  mark'  v.  ill  ^^crvc  as  a  guide  for 
xci'tical  dii'cction,  while  the  caNily  niai'gins  on  the  cavo-surfaces 
will  determine  the  dii'ecticm  which  ihe  hui'r  will  take  in  the 
tooth. 

It  will  be  readily  realized  thai  win  ii  Ihe  inlay  is  again 
])lace(|  ill  ])osition,  the  two  de])i'essioiis  or  iccesses  on  the  inlay, 
will  iiKM'l  Hie  two  recesses  within  Ihe  tooth,  and  an  almost  cir- 
ciilar  ]•' sistaiK'<'   |iini(ni   will    result    upon   the  application   of  the 


roi.lSIIIXC    AXIt    CK.MKXTATKIX    Ol"    IXI^AV  215 

cement.  Such  resistance  |)ini()iis  are  exceed iii^^ly  sti'oii;;'  and 
very 'ditlficiilt  to  obliterate,  since  tlie\'  jjossess  tlie  niaxiinnin  hulk' 
Avlierc  tension  is  <;reatest. 

Tlie  accuracy  of  the  ])r()xiinale  relation  of  tlie  inlay,  must 
l)e  satisfactoi-y ;  tliei'e  must  be  contact  with  the  next  tooth,  if 
any  be  present,  il'  the  iida\'  be  a  compound  on'',  and  il'  it  be 
one  for  any  tooth  distally  to  the  first  bicusjud,  tliei'e  must  be 
coiitdcl  lilies  inster.d  of  cn/fdcl  jioitifs. 

If  any  delicieiic\'  be  obsei'ved  at  these  pai'ts,  it  may  l)e 
rectilied  by  (h)ul)lini;'  a  cylinder  of  i!,()ld  toil  uj)<)n  itsell',  and 
placing-  it  snui^ly  u|)()n  the  delicient  ])art  of  the  iida\'  witli  tlie 
smallest  quantity  of  '2'2  carat  solder,  this  cylinder  is  joined  to 
the  inlay  ))ro])er,  and  the  bulk  of  it  at   that   |)oiiit  is  increased. 

The  necessity  tor  sucli  ste})s,  as  described  immediately 
al)ove,  will  become  I'ai-ei-  as  the  technic  is  mastered. 

It  will  be  recalled  that  tlie  inar,ii,ins  of  the  inlay  were  ])ol- 
ished  by  the  use  of  the  burnishers,  while  it  was  in  the  tooth 
cavit}^  The  rest  of  it  is  now  liuished  with  tin(>  cuttle-tish  discs, 
to  be  followed  by  ci'ocus  discs.  The  occlusal  surface  having;' 
been  found  correct,  it  is  ])olislied  with  small  bi'usli  wheels  and 
pumice,  and  finally  with  felt  wlieids,  and  j^ointed  slender  engine 
burnishers.  If  there  has  been  a  sli])-up  on  the  occlusal  surface, 
the  inlay  is  ]3ut  into  the  cavity,  carefully  seated,  and  th(»  ])atient 
is  asked  to  brin.i;'  the  teeth  into  occlusal  relation,  while  a  small 
piece  of  thin  articulating;"  j^aper  is  held  over  the  tooth  that  con- 
tains the  inlay.  In  this  manner  the  interfering  high  points  will 
be  readily  noticed  and  may  be  removed. 

The  necessity  for  this  ])roce(lure  also  will  grow  less  fre- 
quent, as  the  knowledge  of  both  the  process  and  the  technic 
grows  with  practice. 

When  the  inlay  has  been  sul),jecte(l  to  all  necessary  trials, 
when  the  recesses  have  been  made,  and  the  inlay  has  been  pol- 
ished, we  are  ready  for  cementation.  Use  the  rubber  dam 
whenever  at  all  i)ossible.  It  is  so  much  easier  to  keep  the  field 
of  operation  dry,  and  the  cavity  thoroughly  clean;  steriliza- 
tion of  the  cavity  is  so  much  more  readily  accomplished;  and 
the  operation  is  so  much  more  of  an  assured  success,  that  all 
arguments  are  in  favor  of  the  rubber  dam. 

In  cases  in  which  it  is  impossible  to  use  the  rul)l)er  dam 


216  CAST    tlOLD    AXD    POltCELAlX    IXLAYS 

(a  condition  whicli  is  oxceedingly  rare)  the  clamp  may  be  ad- 
justed on  the  tootli  to  be  tilled,  or  the  one  hnmediately  behind 
or  in  front  of  it,  if  the  tooth  be  an  upper  one;  or  the  saliva 
ejector  of  Xyman  may  be  used,  if  the  tooth  be  a  lower  one. 
These  saliva  ejectors  were  designed  by  Dr.  Nyman,  of  Chicago, 
and  offer  an  excellent  means  of  keejjing  the  held  of  operation 
fairly  dry  with  the  aid  of  cotton  rolls. 

Of  course,  napkins  or  cotton  rolls  may  l)e  used  when  the 
clamj^s  are  being  relied  u])on  to  keep  the  operating  area  more 
or  less  isolated. 

AVe  will  assume  that  we  have  been  able  to  apply  the  rubber 
dam.  and  thus  are  enabled  to  successfully  isolate  the  tooth  we 
are  working  on,  as  well  as  several  adjoining  ones. 

The  cavity  is  thoroughly  dried,  as  well  as  cotton  will  dry 
it,  a  fresh  pledget  of  cotton  is  dipped  into  warm  alcohol,  and 
the  cavity  is  flushed  with  this;  the  walls,  as  well  as  the  seat,  of 
the  cavity  are  carefully  rubbed  with  this  pledget  of  alcohol- 
carrying  cotton. 

This  is  kept  up  for  a  minute,  when  a  stream  of  warm  air 
will  dry  the  tooth.  A  pledget  of  fresh  cotton  is  now  dipped 
into  a  solution  of  warmed  bichloride  in  ^\,()2  1-250,  and  this  is 
l)ut  into  the  cavity  and  allowed  to  remain  there  froin  three  to 
five  minutes  while  preparations  are  made  for  the  mixing  of  the 
cement. 

A  dry  cement  slab  is  essential.  Any  good  reliable  cement 
of  an  exceedingly  fine  grain  and  preferably  of  brown  color  will 
do.  A  broad  spatula  of  German  silver  or  agate  or  l)one  slioidd 
be  used,  and  tlie  cement  must  be  rather  thinly  mixed,  but  very 
thoroughly  spatulated.  Spread  the  mix  over  as  large  an  area 
as  possible;  the  more  you  can  spread  it  out,  the  thinner  the 
layer,  the  better  the  mix,  the  more  thorough  this  incorporation 
of  powder  into  liquid  has  ])een. 

The  inlay  has  in  the  interim  ])een  washecl  l)y  the  assistant 
or  operator  himself  and  di'ied  with  warm  air. 

The  bicliloiidc  is  l•('lllo^■('d  I'l-om  the  loolli  and  llie  cavity 
is  dried  with  cotton  and  again  IIusIumI  with  ah-ohol  and  dried 
with  warm  air. 

A  jifi"y  cement  tube  is  liMed  with  the  cement  and  a  thin 
layer  of  tlic  mix   is  s])i-ead  over  the  cavo-sui'lace  of  the   iiihiy. 


roLismxc  and  ch.mkx'I'aiion   oi'  inlay  217 

The  coiitciils  of  the  .jiHN'  liihc  arc  expelled,  directing'  tlieiii  iiit(j 
the  ('a\ity.  hy  liii^ci'  ])ressur(',  and  the  iiday  is  grasped  witli  a 
])air  of  tweezers,  oi"  the  fingers,  and  guidecl  to  its  position  over 
and  into  tlie  cavity.  The  gi'eatest  care  nnist  Ix'  nsed  in  seating 
the  inlay  at  this  time,  and  again  gentle  tai)j)ing  ratlier  tlian 
sudden  force  will  aeeomplish  tlie  desired  end. 

Grasp  a  ])ointed,  notched  jiardwood  instrnnient  of  consider- 
ahle  strengtli,  in  eacli  hand,  an<l  liohling  l)otli  of  tliese  points 
upon  the  inlay,  gently  rock  it  into  })lace,  while  the  surplus  ce- 
ment is  being  forced  out.  WIkmi  Hk^  inlay  is  neai'ly  in  j^lace, 
the  wood  sticlv  fi-om  the  right  hand  is  laid  aside,  and  the  mallet 
is  called  uj)on  to  ruithcr  the  work  until  the  inlay  is  seated.  The 
stick  is  thcMi  suhstituted  foi"  the  mallet  and  tlu^  inlay  is  held 
there  for  tifteen  or  twenty  minutes,  the  same  position  being 
maintained  as  nearly  as  possible.  Be  sure  the  inlay  is  in  its  seat 
and  do  not  rock  it  after  that. 

Xo  burnishing,  no  malleting,  no  polishing,  no  trinnning 
down  of  any  kind,  for  at  least  a  day  after  cementation.  AVlien 
the  cement  has  crystallized,  the  rubber  dam  is  removed,  the 
surplus  cement  around  the  inlay  is  removed,  and  the  j^atient  is 
cautioned  against  using  ttiat  tooth  or  that  side  of  the  mouth 
for  the  next  few  hours  to  come,  in  order  to  jn'operly  preserve 
the  continuity  of  the  cement  while  it  is  hardening. 

Upon  the  return  of  the  patient  for  the  next  sitting  the 
nuirgins  may,  if  necessary,  be  burnished;  the  right  and  left  bur- 
nishers may  be  used  as  indicated,  or  the  small  engine  burnishers 
may  be  employed. 

If  all  directions  have  been  carefully  followed,  this  will 
rarely  if  ever  be  required,  but  should  the  necessity  arise,  it  is 
well  to  remember  that  the  burnishing  is  to  be  done  in  line  with, 
and  not  against,  the  margins  of  the  cavity. 

SUMMARY   FOR   CHAPTER   XVI 

Removal   of  the  Excess  of  Metal,   the  Polishing  and  Cementation   of  the  Inlay 

J.  Dc'serilio  tlic  i)ii']ia ration  of  tlio  inlay  licfore  it  is  tricil  in  the  cavity. 

2.  Describe  the  tost  fitting  of  the  inlay  iu  the  cavity. 

3.  In  what  manner  should  the  margins  be  burnished? 

4.  Descrilje  the  making  of  the  resistance  pinion. 

5.  How  would  you  restore  the  contact  point  of  an  inlay? 

C.  Descrilje   the  polishing  of  the   inlay  before   it   is   ready  for   cementation. 
7.  Describe  the  cementation  process. 


CHAPTER  XVll 

TJIE  JSPJJXTlXiJ  OF  l.OO^E  TEETH  BY  .MHLVNS 
OF  INLAYS 

The  Splinting  cf  Loose  Teeth  by  Means  of  the  Cast  Gold  Inlay,  and 

the    Paralleling-   cf   the   Root   Canals    of    Loose   Teeth  that   Are 

to  Be  Splinted,  by  Means  of  Instruments  Known  as  the 

Parallelometer  and  the  Parallelodrill,  Respectively 

The  spliiitiii.L;'  (•!'  loose  Iceli!  lias  always  l)eeii  a  iiioi-e  or  less 
difficult  task  for  tlie  o])erator  to  ]:)orl:'oriii.  Particularly  does 
this  a])])ly  to  the  splintin,i;'  ot'  anterior  uj^iier  or  hjwer  teeth. 

The  reason  for  this  heeonies  obvious  wlitn  we  consider  the 
position  of  tlie  up])er  anteriors  and  their  longitudinal  relation 
to  each  other,  and  wlien  we  take  into  consideration  the  size  and 
I'di-iiiation  of  the  lower  anteriors. 

.  Tlie  first  genei-al  princi])le  to  lie  observed  is  that  we  must 
never  I'eniove  enough  tooth  structui'e  from  the  inner  part  of  the 
tooth  to  endanger  its  ])ossil)ility  of  ])laying  its  ])art  in  the  con- 
tinuous ilow  of  \ital  ess' nee.  In  other  words,  we  must  never 
ream  out  or  drill  a  canal  so  that  only  a  tliin  bony  shell  will 
remain  in  tli"  aUcolai'  socket,  foi'  if  we  do,  not  oid\'  will  the 
>]i('ll  be  likely  to  split  undei'  stress,  bnt  the  maintenance  of 
nuti'ition  is  a  nuu-h  more  dithcult  thing  in  a  thin  layer  consist- 
ing lai'gely  ol'  inoi-ganic  inatei'ial,  and  whei'ein  the  major  ])art  of 
tlie  channels  of  nnti'ition  have  been  segre!!,ate(j  From  each  otliei* 
(tlieir  anastomoses  dest i'()yed),  than  it  would  }>o  in  a  thicker 
mass  in  which  the  tnhnles  still  coinnMinlcate  with  (  ach  other 
and  so  cari'V  the  \i1;il  essence  to  e\'ery  cell. 

The  prolileiii  of  estahlishing  a  parallel  relation  between  the 
canal.-  of  tln-e  lectli,  witliont  desi  iiicl  ion  of  too  inncli  of  the 
\'alnal»le  intert  w  i  iiiiii;'  nntriiiient  canyiiig  tnhnles,  led  the  writer 
to  the  in\eiilion  ol'  certain  instrnnients  which  ai'e  respec{i\-ely 
k'nown    as    a    p;ir;dle|onie1er   .-ind    ;i    parallelodrill.      ^The    nse    of 

218 


SPLixTiXd   i.oosK  TKF/nr   wi'i'ii    l^•|>.\^■s 


219 


Fig.  176. — Showing  the  parallelometer  wrench  in  position  on  locking  stud. 
You  will  note  that  stud  is  the  only  one  on  the  parallelometer  which  has  no 
clamp  connected  with  it.  When  the  distance  which  the  operator  wants  to  main- 
tain has  been  reached,  this  stud  is  turned  up  tightly  and  the  meter  is  locked 
beyond  any  possibility  of  change.  Groat  care  should  be  taken  by  the  operator 
to  always  see  that  this  stud  is  loosened  before  attempting  to  turn  the  actuating 
screw  of  the  parallelometer.  This  screw  has  96  threads  to  the  inch,  and  could 
verv  easily  be  damaged  or  jammed,  if  the  locking  stud  were  turned  up  tightly 
and  an  attempt  made  to  turn  the  actuating  screw. 


Fig.  177. — In  order  to  make  clear  the  correct  position  for  the  various  man- 
drels for  different  distances,  the  following  cuts  are  shown  for  guidance. 

In  the  above  cut,  the  measuring  posts  are  in  position  for  all  measurements 
from  6  mm.  up  to  and  including  10  mm.  Six  millimeters  is  the  minimum  distance 
that  can  be  measured  with  this  instrument. 


220  CAST    (.;()LD    AND    roltt'KLATX    IX LAVS 

tliesc  instriiiiieiits  is  a  simple  procedure  and  makes  the  parallel- 
ing of  any  lumiher  of  teeth  in  the  arch  a  definite  and  mechan- 
ically accurate  task. 

Let  us  assume  thai  we  are  al)()ut  to  make  a  sjilint  for  the 
six  anterior  u])])(m-  leetli  and  that  all  root  work  has  been  j^rop- 


Fig.  178. — Measuring  posts  in  same  clamps  as  in  preceding  cut,  but  with 
the  distance  between  them  increased  to.  10  mm.  This  is  the  maximum  distance 
that  can  be  measured  with  the  posts  in  these  clamps. 


Fig.  179. — Showing  position  of  jiieasuriug  posts  for  all  measurements  from 
10  mm.  up  to  and  including  2.1  mm.  Tiie  above  is  tlie  niaxiiiiuni  distance  that 
can  be  measured  Avitli   the  ])osts  in   these  clani])s. 

ei'ly  <'X<'cutc(l,  tlial  llic  canals  have  hccn  filled  J'or  their  gingival 
lialf,  and  llial  no  nndiir  n-aniiiig  onl  of  the  roots  has  heen  I'e- 
sortc*!  1o.      W'c  shall   nsc  a    ITj-gnngc   (  llrow  n   cV:   Siiar]))    .'>()  j)er 


SPLINTIXC    LOOSIO    'I'l'll'mi     WITH     INLAYS 


221 


ct'iil    iridi()-i)latiiiiiiii    wire   I'oi-  llic   ciisiiids   and   cciiti'als   and   a 
16-gauge  wire  Tor  llic  lateral  iiicisoi-. 

ENcrytliiiii;-  hciiii;'  i-cad}'  I'oi'  parallcliii,!;'  Ilic  canals  of  lliese 
toctli,  we  turn  oiii-  allciil  ion  to  the  inst  I'liiiicid  known  as  a 
l)aralleloinet('r  and  note: 


Fig.  ISO.^Mcasuiing  posts  in  same  clamps  as  in  Fig.  179,  but  "with  the 
distance  increased  to  40  mm.  This  is  the  maximum  distance  that  can  be  measured 
with  the  posts  in  these  clamps. 


Fig.  181. — When  the  distance  to  be  measured  exceeds  -40  mm.,  the  parallelom- 
eter is  reversed  and  the  measuring  posts  are  placed  in  the  clamps  as  shown  above. 
These  posts,  as  can  be  seen,  are  now  35  mm.  apart.  The  parallelometer  may  be 
extended  to  55  mm. 


1.  It  consists  of  two  r(H'tan<;ular  i^ieces  of  metal,  slidaldy 
adjiistal)le  one  npon  tlie  otlier,  a  screw  providing-  tlie  means 
of  motion. 


!'__  CAST    COIJ)    AND     I'OltCKLAlX     I^•1,A^•S 

2.  At  lixed  distaiUH  s  ii])()ii  tlic  ])i('ce  of  metal,  certain  clamps 
are  j)resent,  which  will  ii])()n  l)eiiii;'  locked,  (h'fmitely  liold  a 
givon  wire  in  a  fixed  groove. 

i).  The  ii])])er  surface  of  the  engaging  sections  is  accu- 
rately graduated  in  millimeters,  a  constantly  augmenting  num- 
l)er  of  turns  of  the  sere  w  JKung  necessary  to  traverse  a  milli- 
meter space  as  the  first  groove  upon  the  tal)le  section  and  the 
last  groove  upon  the  movable  section  approach  each  other. 
This  instrument  will  line  uj)  I'oot  canals  parallel  to  each  other, 
when  they  are  7  or  40  mm.  a])ai-t,  and  we  nmst  hear  in  mind 
that: 

First.  If  we  wish  to  jjarallel  the  canals  of  two  teeth  which 
are  over  7  mm.  and  less  than  10  mm.  apart,  we  clanqo  a  wire  of 


i'ig.  Ih2. — Measuring  posts  in  same  clamps  as  in  Fig.  181,  but  the  distance 
has  been  increased  to  55  mm.  This  is  the  maximum  range  of  the  parallelometer 
and  will  reach  from  any  part  of  the  month  to  any  othfM'  part  of  the  mouth. 


suitahle  gauge  into  the  two  oj^posite  grooves  farthest  away  from 
the  actuating  screw. 

Second.  When  the  canals  to  l)e  paralleled  are  more  than 
10  and  less  than  25  mm.  apart,  we  use  the  end  groove  of  the 
stable  section  as  our  unit  ])oint,  and  the  middle  grove  of  the 
movable  section  as  oiii-  ])oint  of  accommo<lation  or  adjustment. 

Tliii'd.  When  tlie  canals  to  he  paralleled  are  more  than  25 
or  less  than  40  mm,  apart,  we  use  the  end  groove  of  our  stable 
section  as  oui'  unit  ])oint,  and  that  groove  u])on  the  movable 
section  which  is  nearest  the  actnating  sci-ew  as  oni-  ])oint  of  ac- 
eonnnodalion  oi'  adjustment. 

(iiven  a  case;  wliieh  recpiii'cs  splinting  of  the  six  anterior 
teeth,  wo  would  then  jiroceed  as  follows: 


si'MN'i'i xc   I. <)()>!•:  'i'i':i':'rii    wriii    l^■|>.\^•s 


223 


].  'IMic  Icclli  iimsl  l)c  1  !i()r()ii,i;Iily  sc.-iNmI  jiikI  polished. 
'2.   All  suppiiralixc  coiidil  ions  iiiiisl  he  cliiiiiiiatcMl. 
',].   All  llic  pulps  iimsl  ])v  cxlirpatccl  and  11i<'  I'oots  filled  for 
llicii- .i;iti,i;i\al  half  in  accoi'dancc  with  the  hcst  Icchnic. 

4.  'riic  iiicisal  oriliccs  ol'  the  pulp  chanihers  are  enlarged 
hy  means  of  st<)n<>s  siiitahlc  in  sliap<'  and  size. 

5.  Stai'lin.i;'  willi  the  two  ('us))ids,  they  will  Ix'  found  to  l)e 
more  than  l^.")  mm.  an<l  less  than  40  nun.  a])art,  and  we  sliall 
therefcn-e  clamp  two  ir)-o-auf;-e  (Bi'own  &  Sliar]))  steel  rods  into 


Fit;-.  ]8.'l. — The  al)ov(>  cut  sliow.s  where  the  paiallelodiill  shouhl  bo  oi!c<l.  A 
drop  of  oil  sliould  Ijc  placed  in  C  and  D  occasionally;  the  cap  at  B  should  be  re- 
moved, and  the  pinion  uiidrnii'ath  it  oilcil ;  also,  the  caps  at  A  and  ./.  Tlic  latter 
caps  have  a  left-hand  thread. 

The  parallelodrill  cannot  he  sterilized  l)y  boiling,  due  to  the  fact  that  certain 
pinions  and  parts  are  made  of  steel,  the  drill,  however,  may  be  entirely  dissembled 
and  easily  reassembled,  and  all   jiaits  wiped  off  carefully. 

A  centering  post  is  provided  in  the  set  of  instruments  to  assist  assembling  the 
parallelodrill  when  it  has  been  taken  apart  to  be  cleaned.  This  centering  post  is  the 
same  size  as  the  center  stud  which  holds  the  two  drill  heads,  pinions,  etc.,  together. 
Instead  of  aligning  the  abovO'  parts  with  the  center  stud,  th.e  centering  post  should 
be  used,  and  in  that  way,  no  harm  will  bo  done  to  the  thread  of  the  stud. 


224 


CAST    (iOLD    AND    PORCKLAIX    IXLAYS 


tlie  coiTespondiiig  grooves  presenting  tliemselves  njion  tlie  oji- 
])osite  sides  of  tlie  ])arallel()iHeter. 


Fig.    184. — Di~taiifO   established   between   cuspids.      The   drills   are   too   be   the   same 

distance  apart. 


Fig.  185. — Showing  the  operation  of  the  parallelodrill  reaming  out  two  rout 
oanals  in  tlio  two  upper  cuspid.s  to  reci?ive  the  split  pin  and  tube  attach mouts.  Note 
the  position  of  the  operator's  left  hand  in  supporting  the  paralhlnili  ill  dniing  this 
operation. 


fi.  AVe  join  the  actnating  screw  nntil  the  two  posts  or  wires 
will  just  enter  the  root  canals  of  the  two  cnspid  teeth. 

7.  Kenioving  tlie  instrument  from  the  mouth,  w^e  fix  the 


SIM.IXTIXd    KOOSK    'I'KK'I'II     WITH    IXr.AVft  225 

distance  Ix'twccii  llii'  two  ])Osts  hy  lueaiis  of  llie  lock  nut  i^ro- 
vidod  and  we  I'ccord  tliis  distance  for  future  reference. 

8.  AVe  remove  the  two  wires  from  their  respective  grooves 
hy  opening  tlie  elam])s  and  we  substitute  two  short  posts  wliich 
we  accurately  chimp  into  tlie  meter,  and  whicli  will  engage  the 
two  lieads  of  the  parallelodrill. 

9.  The  drill  heads  of  the  parallelodrill  are  now  made  to 
engage  the  protruding  ends  of  the  short  posts,  and  the  distance 
hetwcH'ii  the  drill  heads  is  fixed  by  turning  the  lock  nut  pro- 
vi(l(d. 

10.  The  parallelodrill  is  removed  from  the  posts,  clamped 
into  the  parallelometer  and  two  drills,  corresponding  in  size  to 
the  original  wires,  are  now  inserted  into  the  drill  heads. 

11.  The  parallelodrill  is  mounted  onto  the  handpiece  of  the 
engine  and  the  drill  heads  carrying  the  two  drills  are  brought 
into  line  with  the  canals  of  the  two  cuspids. 

12.  The  power  is  turned  on  and  the  drills  are  allowed  to 
sink  into  the  two  root  canals  to  the  required  depth. 

13.  This  varies  directly  as  the  amount  of  destruction  of 
the  alveolus  and  the  recession  of  the  gum  and  inversely  as  the 
divergence  of  the  roots. 

14.  The  drills  must  be  sharp,  allow  for  clearance,  the  hand 
must  be  steady  and  the  mind  must  be  fixed  upon  the  task  in  hand. 

15.  It  will  be  found  that  the  canals  in  the  cuspids  will  be 
parallel  without  difficulty  and  with  the  least  sacrifice  of  tooth 
structure. 

We  shall  now  j^roceed  to  i^ai'allel  the  right  cuspid  to  the  left 
lateral  or  rather  the  left  lateral  to  the  right  cusiDid. 

Taking  up  the  instrument  called  the  parallelometer  we  re- 
lease the  lock  nut  which  will  enable  the  actuating  screw  to  func- 
tion, then  proceed  as  follows: 

1.  The  clamp  which  holds  the  wire  upon  the  accommodating 
section  in  the  groove  nearest  the  actuating  screw  is  opened  and 
the  wire  is  removed. 

2.  The  space  between  the  right  central  and  the  left  lateral 
becomes  more  than  10  mm.  and  less  than  25  mm.  apart.  This 
wire  is  clamped  into  the  middle  grove  of  the  movable  or  ac- 
conmiodating  section. 

3.  The  actuating  screw  is  turned  until  the  two  wires  will 


226 


CAST    (lOl.D    AXD    POIK'KI.AIX    IXLAYS 


be  ill  line  Avitli  tlie  iiicisal  orifices  of  the  canals  of  the  right  cen- 
tral and  left  lateral  respectively,  and  will  just  enter  these  canals. 

4.  The  parallelometer  is  removed  from  the  month  and  the 
distance  between  tlie  two  Avires  is  noted,  recorded,  and  fixed  by 
turning  the  lock  nut  provided. 

5.  The  clamps  holding  the  wires  are  opened,  the  latter  are 
removed  and  the  short  drill  guides  or  alignment  posts  are  placed 
into  the  grooves  and  the  clamjDS  are  locked. 


Fig.   186-J. 


Flii-.   1S6-B. 


Fig.   186. — Showing  tlie  motiiod   of  tiaiisforiiiig  tlio   distaiu-e   from   tlie   paial 
klometer  to  the  parallelodrill. 

1.  Measuring  jiosts  in  jxisitinn  al'trr  having  the  distance  increased  Ix'tweeii  them 
by  21/2  mm. 

'^.  Alignment  posts  have  liecii  sulistitutcd  for  ni^asuiing  posts  and  tiglitcncil 
u])  in  their  respective  clamps. 

'.').  Parallelodrill  has  lieen  unlocked  and  tlie  two  diillheads  superimjiosed  on  the 
pyramidal-shaped  alignment  posts.  The  handle  of  the  drill  has  lieen  turned  to  the 
most  convenient  angle  for  the  woik  to  lie  done  in  the  iiKJiifh,  and  tlie  two  drilllicads 
locked   in  that  position. 

4.  The  parallelodrill  leinoved  fioni  alignment  jiosts  with  llic  distance  accurately 
transferred  from  the  parallelometer  to  the  parallelodrill. 


si'MX'i'i.\(i   i.oosi':  'I'lii'yni    wrni    l.\l,A^•s  227 

().  Tlic  parallclodrill  is  dcpriNCMl  of  its  di-ills,  the  lock  nut 
upon  its  ('(Mil(=i'  is  opened,  and  the  two  diill  heads  are  made  to 
on<;'a<;-e  tlio  extending'  ends  of  the  diill  ,<;uides  or  ali4;iiinent  posts 
\vhicli  are  clamped  in  the  meter. 

7.  The  distance  hetwee])  tlie  drill  heads  is  fixed  !)>■  turning;- 
tlie  lock  mit  |)i'o\'i(le<l,  and  the  di'ill  head  wliicli  is  to  he  oposite 
the  lateral  incisor  is  i)r()vided  with  a  diill  of  suitable  size  and 
make,  while  the  one  wliicli  is  to  coact  with  the  cus])id  is  made 
to  carry  a  smooth  wire  of  the  same  cali))er  as  the  drill  previously 
used  in  ])arallelini;-  the  cuspids. 

S.  The  ])arallelodrill  is  sli])])ed  into  tlie  hand])iece  of  the 
engine,  and  the  drill  and  the  <;iiide  wire  are  hroug'lit  into  line 
with  the  respective  canals. 

J).  The  ])()\vei-  is  turned  on  and  the  drill  is  allowed  to  find 
its  way  into  the  canal  of  the  lateral,  the  guide  wire  in  the  other 
drill  head  entering  the  canal  of  the  cuspid,  will  provide  the 
means  of  compelling  alignment  of  left  lateral  to  right  cuspid. 

10.  The  right  cuspid  canal  having;  been  made'  paiTillel  to 
the  left  cuspid  canal,  at  the  initial  alignment  operation,  the  left 
lateral  Avill  of  course  be  found  parallel  to  the  left  cuspid. 

11.  If  we  now  reverse  the  process,  that  is,  if  Ave  now  turn 
our  attention  to  the  left  cusjiid  and  right  lateral,  employ  the 
same  technic  outlined  above,  merely  transferring  our  drilling 
member  to  the  oposite  drill  head,  Ave  may  readily  bring  into 
parallel  alignment  the  right  lateral  Avitli  the  left  cuspid,  and 
hence  also  Avitli  the  right  cus]^id,  and  hence  also  Avith  the  left 
lateral. 

12.  In  like  manner,  the  canals  of  the  right -and  left  central 
may  be  made  parallel  to  the  left  and  right  cuspids,  respectively, 
and  you  avIio  liaA^e  l)een  Avorking  in  the  dark,  guessing  at  the 
parallelism  of  your  splint  posts  haA^e  a  revelation  awaiting  you, 
Avhen  you  follow  the  technic  outlined  above. 

Exactly  the  same  technic  Avould  have  to  be  folloAved,  if  the 
loAver  anteriors  Avere  the  ones  to  l)e  Avorked  upon,  except  that  the 
Avires  and  drills  to  l)e  used  Avould  have  to  l)e  smaller. 

The  average  size  posts  for  the  four  loAver  incisors  is  17- 
gauge  (BroAvn  &  Sharp),  Avliile  the  cuspids  Avill  take  a  lo-gauge 
Avire  of  the  same  standard. 

If  noAv  the  six  anteriors,  ui:)per  or  loAver  teeth  Avere  to  be 


228  CAST  udLD  Axn  ror.cELAix  inlays 

s2)liiiUHl,  l)y  moans  of  cast  gold  inlays,  and  the  two  cuspids 
wore  to  1)0  used  as  ahuimouts  for  a  hridge,  as  frequently  tliey 
umst  he,  the  procedure  wouhl  1)0  to  sul)stitute  tuhes  for  the 
jDOst,  wliich  Avere  to  he  inserted  into  tlie  root  cauals  of  the  cus- 
])ids. 

The  technic  for  paralleling  would  he  the  same  as  previously 


Fig.  187. — Distance  established  between  cuspid  and  lateral  on  opposite  side 

of  the  arch. 


Fig.   188. — DistuMce   establi.shed  between   right  cu.spid  and  left  lateral. 
Drills  are  the  same  distance  apart. 

outlined,  except  that  the  i)osts  used  in  aligmnont  of  the  upper 
cuspids  would  be  13-gauge  (Brown  &  Shari^),  while  the  drills 
which  are  to  sink  llie  shafts  are  a  No.  12  (Brown  &  Sliarp),  and 
for  the  lower  cns]>ids  14-gauge  wii'o  (Bi'own  &  Sharp)  would  he 
used  to  he  followed  with  a  l.']-gauge  drill. 

When  tlie  canals  in  the  cuspids  have  boon  ])aralleled,  the 


SPLIXTIXC    I.OOSI-;    TKK'I-II     WTI'll     IXI.AVS  '2'2\) 

cavities  are  cut  into  tlie  teetli,  liiiguo-distally,  occupying  a 
goodly  portion  of  tli(»  lingual  surface  and  extended  niesially  so 
as  to  almost  reach  tlic  labial  surface. 

'Ilic  ])arall('l()iii('t('i-  carrying  two  wire  posts  13-gauge 
(Brown  &  Sliai'j))  clani])('d  in  tlieir  respective  grooves  is  now 
iitted  into  t1i<'  ])arall('l  canals.  The  instrument  is  removed  from 
the  moutli,  and  tlic  distance  between  the  posts  is  noted,  recorded, 
and  fixed  hy  hii-iiing  the  lock  nut. 

Two  friction  angle  trays,  pro])ei'ly  ]ul)ricated,  are  now 
mounted  upon  ])()sts  and  two  ])latinum  tubes  are  slipped  over 
and  onto  the  posts,  the  wall  of  these  tubes  is  .007  mm.  thick. 
The  trays  are  moved  up  the  wires  until  the  incisal  end  of  the 
tubes  will  disappear  into  the  sleeves  of  the  trays. 

Inlay  wax  is  now  melted  upon  the  tray  and  around  the  tube, 
the  outer  wall  of  which  luis  been  knurled  by  rolling  it  under  a 
fine  file.  The  wax  is  built  up  into  the  shape  of  a  small  pj^ramid 
upon  both  trays,  and  the  instrument  noAv  carrying  trays,  Avax 
and  tubes,  is  guided  back  into  the  root  canal  of  the  cuspid  teeth, 
and  forced  into  i)osition.  The  trays  carrying  the  wax  are  now 
brought  uj)  so  that  the  wax  will  be  forced  into  the  cavity.  A 
stream  of  cold  air  is  directed  upon  the  cuspids,  while  the  trays 
are  held  in  this  position,  until  the  wax  has  stiffened  beyond  the 
possibility  of  change  and  form. 

The  instrument  is  now  removed  from  the  mouth,  and  with 
a  small,  sharp  lancet,  the  surj^lus  of  wax  is  cut  or  carved  away. 
The  clamps  which  hold  the  wires  in  the  respective  grooves  upon 
the  meter  are  opened,  and  the  wires,  which  carry  tray,  wax 
and  tubes  are  released.  A  pin  vise,  held  in  the  right  hand, 
grasps  the  tube,  while  the  left  hand  carefully  moves  the  tray 
downward  u])on  the  wire,  and  finally  the  tube  and  wax  inlay 
as  one  are  remoA-ed  from  the  wire.  AVitli  a  lancet  and  proper 
carvers,  the  lingual  portion  of  the  wax  inlay  is  now  carved  out 
into  a  retentively  formed  cavity,  to  be  subsequently  occupied 
by  an  inlay,  which  carrying  a  split  pin,  will  engage  the  platinum 
tube,  and  which  iiday  and  split  pin,  in  conjunction  with  the  one 
upon  the  opposite  side,  will  l)e  joined  to  the  bridge  to  serve  as 
attachments  for  it. 

A  graphite  post  from  which  the  oil  lias  been  thoroughly 
burned  out,  and  which  is  of  the  same  caliber  as  the  wire,  which 


c\^ 


COIJ)    AXD    roiU'KLAlX    IXl.AVS 


lilted  into  tlio  platimiiii  tiiho,  is  now  inserted  into  the  tube,  a 
sprue  wire  is  lieated  and  inserted  into  that  portion  of  the  Avax 
inhiy  Avhieh  is  thickest,  and  farthest  away  from  the  phitinmn 
tuhe.  The  sprue  wire  is  inserted  in  such  an  angle  that  the  mol- 
ten gold,  upon  being  forced  into  the  mold,  will  not  strike  the 
tul)e  as  an  ol)struction,  in  its  travel,  hut  will  raher  have  a 
chance  to  attach  itself  to  it  in  an  enveloping  maner. 


Fig.  189. — Distance  established  between  left  cuspid  and  right  central. 
Drills   are  the   same   distance   apart. 


P'ig.  190. —  Di.'^taiico  estal)li.slicd  l>otweoii  right  cuspid  and  left  central 
Drills   are  the   same   distance   apart. 


TIk'  cavities  in  ;ill  11i<'  aiilcfior  teeth,  which  arc  to  he 
spliiili'd  logellicr,  iiiiisl  lie  cxli  ii<l('(l  inesio-dislallv  in  such  a 
iiiaimci-  llial  llic  iiil;i\s  1li;i1  ;iit  in  lie  made  I'oi-  lliese  cavities 
may  Ix-JoiiKMl  lo  one  ainil  licr  willi  a  siiriiciciil  (jiiantity  of  solder 
to  ])i-ovidc  the  necessary  strciigili,  and  xcl,  williout  that  solder 
coming  uj)  to  any  of  the  inai'gins,  so  Uial  tlicre  may  he  no  dif- 


si'LiXTiXd   i.oosK  ■n':K'i'ii    wri' 


IX  LAVS  231 


iicuIlN-  ahoul  llic  jjrojKT  care  in  ]<('r|)iii<;'  llicsc  iiiai'<i,iiis,  between 
inlay  and  cavity,  perfectly  clean. 

These  iiilaxs  for  llic  liii^^ual  surFaccs  of  the  tectli  whlcli  arc 
to  l)e  s])liiiic(l  arc  most  easily  made  in  llic  following  manner: 

A  threaded  ])()st  of  the  ])roj)er  diameter  is  made  to  pierce 
a.  cone  of  iiday  wax;  a  piece  of  (ieiiiiaii  silver  plate  ahont  30- 
gange,  and  somewhat  h-n-,i;('r  in  area  than  the  lingual  snrface 
of  the  tooth,  is  perforated  and  sli])])e(l  onto  the  wire  post,  so 
as  to  act  as  a  tray  for  the  wax.  The  wiie,  wax  and  tray  are 
now  insei'ted  into  water  138°  F.  for  al)ont  two  minntes,  and  the 
wire,  grasjx'd  witli  the  tliuml)  and  index  iinger,  the  top  of  the 
fingers  making  a  rest  for  the  (Jerman  silver  tray,  that  portion 
of  the  wire,  which  penetrates  and  extends  l)eyond  a  cone  of  in- 
lay wax,  is  now  ])laced  into  the  root  canal  of  the  tooth,  allowed 
to  occnpy  all  the  depth  i:»rovided  for  it,  and  the  German  silver 
tray  is  hronglit  \\y>  against  the  wax,  thns  forcing  the  same  into 
every  portion  of  the  cavity  not  occupied  by  the  wire.  With 
the  tray  under  ]n'essnre,  a  stream  of  cold  water  is  directed  upon 
the  tooth,  until  the  wax  cones  become  fixed  in  that  position, 
when  the  wire  and  the  wax  inlay  and  the  tray  may  be  removed. 

A¥ith  a  sharp  lancet  all  the  surplus  wax  is  carefully  trimmed 
away,  the  (lerman  silver  tray  is  removed  from  the  wire,  and 
the  wax  inlay  and  post  are  now  replaced  into  the  cavity,  and 
with  the  proper  carvers,  and  flat  right  and  left  burnishers,  the 
wax  is  made  to  acquire  its  proper  disto-linguo-mesial  outline. 
The  post  and  inlay  are  now  carefully  removed  from  the  tooth, 
and  the  sprue  wire  is  inserted  as  previously  indicated  in  such 
a  manner  that  when  the  mold  is  ready  to  receive  the  molten 
metal,  the  post  shall  not  act  as  an  obstruction  to  its  (metal) 
free  ingress  into  the  cavity. 

In  this  manner,  all  the  post-carrying  iidays  for  the  teeth 
involved  are  completed  and  j^laced  into  their  resiDcctive  cavities. 
If  the  teeth  are  very  loose  they  must  l)e  supported  in  joroj^er 
])osition  Ijefore  any  attempt  is  made  to  take  an  impression  of 
the  inlays  as  assembled.  This  is  best  accomplished  in  the  fol- 
lowing manner: 

AVitli  a  silk  ligature  the  teeth  are  drawn  into  proj^er  rela- 
tion to  each  other  and  firmly  tied,  the  ligature  must  be  placed 
as  near  to  the  incisal  edge  as  possible,  without  exposing  it  to  the 


232  CAST    COLD    AXn    PORCELAIN    INLAYS 

likelihood  of  its  slipping,  a  stick  of  De  Tray's  modeling  com- 
ponnd  may  be  softened  and  placed  npon  the  labial  snrface  of 
the  teeth,  extending  from  the  gingiva  np  to  the  incisal  third, 
and  reaching  around  to  one-half  of  the  distal  surfaces  of  the 
cuspids,  lield  in  this  position,  the  modeling  compound  is  chilled 
Avith  a  stream  of  cold  water.  A  plaster  impression  may  now  be 
taken  with  the  inlays  and  modeling  compound  in  position,  and 
when  the  plaster  begins  to  set,  a  stream  of  cold  air  should  be 


Fi<!;-.  19L — Fiiii>licii  .spl'mt  icaily  t«  1)0  insoitod.     Note  the  perfect  alignment  of  the 
liosts.     (Sketch  made  by  Dr.  Leo  Stcru.) 


directed  ii])<)ii  tlic  1ra>-  in  oi-dci-  to  ])r('V('iit  the  heat,  generated 
by  the  crystallization  of  the  ])laster,  from  softening  the  com- 
y)0und  or  a  bhist  of  cold  aii"  may  ])v  ])layed  upon  the  ivixj. 

Wlien  the  ])lastei-  has  hafih'iied,  the  tray  is  removed,  the 
lahial  poi'tioii  of  the  impression  is  lifted  off,  and  usually  the 
imj)rovised  modeling  c()mj)osition  splint  will  come  with  it.  The 
ligature  is  then  removed  from  the  tooth,  and  as  a  rule  this  will 
cause  a  loosening  of  the  lingual  portion  of  the  impression,  which 


Sl'LIXTIXc;    J.OOSK    'I'KK'III     Wnil     IXI.AVS  L'.).) 

iiuiy  now  ])e  roiiiovod.  Tf  the  inlays  have  remained  in  the  teeth, 
eacli  one  is  removed  and  phiced  into  its  corresponding  seat  in 
the  impression. 

W'lu'ii  all  of  llic  inlays  ha\'('  hccn  ass('in])l(Ml  in  the  iinjjres- 
sion,  they  aic  waxed  into  ])osition,  eare  bein<>,'  taken  not  to  let 
the  wax  iiin  onto  any  of  the  margins,  their  tinal  seenrity  in  posi- 
tion l)einf^-  attained  hy  waxing-  a  piece  of  wooden  toothpick  onto 
l)()tli  iin|)r('ssi<)n  and  ])()sl  for  each  inlay,  so  that,  if  we  liave  six 
inlays  in  position  in  the  im})ression,  we  shall  have  six  posts 
rising  in  parallel  i-elation  to  each  other  and  onto  each  of  these 
posts  shall  he  waxed  a  piece  of  wooden  tooth])iek,  the  other  end 
of  which,  shall  he  waxed  onto  the  impression.  AVith  a  camel's 
liair  hrnsh,  the  cavo-snrfaces  of  all  the  inlays  are  covered  with 
graphite  ]:)aste,  the  refractory  compound  is  mixed  to  its  proper 
consistency  (that  of  a  fairly  thick  j^aste)  and  with  this  paste 
the  impression  is  filled,  care  1)eing  taken  to  apply  a  little  of 
the  paste  at  a  time,  using  a  brush  or  a  small  sj^atula  to  build  the 
refractory  compound  into  every  portion  of  the  impression,  and 
around  all  parts  of  the  inlays  and  posts,  until  a  model  of  suffi- 
cient size  has  been  secured. 

The  refractory  compound  is  allowed  to  harden  sufficiently 
to  prevent  displacement  of  any  of  the  parts  during  manipula- 
tion, coincident  with  the  separation  or  cutting  away  of  the  im- 
pression. This  cutting  away  process  nmst  be  carefully  done. 
AVe  nmst  bear  in  mind,  that  all  our  efforts  are  directed  to  leave 
the  inlays  in  the  same  relative  position  upon  the  refractory 
model,  which  they  occupy  in  the  mouth. 

When  the  impression  has  l)een  entirely  removed  from  the 
model,  the  inlays  situated  in  the  model  are  carefully  and  thor- 
oughly cleansed,  an  examination  is  made  to  determine  if  they 
are  in  contact  at  the  i^oints  where  they  are  to  be  joined  to  one 
another,  and  if  they  are  not,  they  are  brought  into  contact  1)y 
carefully  fitting  small  jneces  of  clasp  metal,  or  iridio-platinum 
into  tliesi^  ])lac('s;  the  line  of  junction  is  carefully  waxed  up, 
while  additional  refractory  compound  is  placed  ujion  all  the 
exposed  parts  of  the  inlays.  After  this  has  hardened,  the  piece 
may  be  placed  upon  the  fire  for  a  few  moments,  when  the  wax 
may  be  removed,  the  piece  may  be  replaced  on  the  flame,  allowed 
to  heat  up  for  another  few  minutes,  Avhen  it  is  fluxed,  and  small 


234  CAST    COIJ)    AND    I'OIU'KI.AIX     IXl.ANS 

pieces  of  soldrr  ])la('ed  at  the  i)()iiits  wIktc  union  is  desired. 
Wlieii  the  piece  has  l)een  thorougiily  lieated  by  the  flame  tlic 
bloAvpii^o  is  applied  and  tlie  inlays  are  soldered  together. 

It  is  advisable  to  alloAv  the  j^iece  to  become  fairly  cool  be- 
fore any  attempt  is  made  to  take  it  out  of  the  model.  Wlien  tlie 
l^roijer  time  comes,  this  may  be  done  and  the  now  joined  inlays 
are  removed  from  their  place  upon  the  model,  thoroughly 
scrul)bed  with  soap  and  water  and  thrown  into  hydrofluoric  acid 
to  remain  for  a  period  of  half  an  hour  or  so.  They  are  removed 
from  the  hydrofluoric  acid,  thoroughly  washed,  and  thrown  into 
a  bath  of  Avarm  hydrochloric  acid,  again  removed,  thoroughly 
washed,  and  boiled  in  a  sodium  bicarbonate  solution.  A¥ith  lit- 
tle stones  held  in  the  engine  handj^iece,  all  excess  is  now  ground 
away.  Care  nmst  be  taken  not  to  encroach  upon  any  margins 
during  our  finishing  and  polishing  operation. 

If  our  patient  is  waiting  for  us  to  complete  the  entire  opera- 
tion outlined  above,  no  particular  provision  for  the  care  of  the 
teeth  that  are  to  be  splinted  need  be  made  except  the  closing 
of  the  various  cavities  by  means  of  temporary  stopping.  But 
if  the  patient  is  to  be  discharged  and  is  to  be  absent  for  several 
days,  pending  the  completion  of  the  splint,  some  provision  must 
be  made  to  protect  and  support  these  loose  teeth  during  that 
time. 

I  have  found  a  most  efficient  method  of  supporting  these 
teeth  in  the  following  manner: 

The  teeth  containing  the  cavities  ai"e  thoroughly  sprayed 
with  wann  water.  Cotton  rolls  are  a])plied  and  the  teeth  are 
dried  with  warm  air. 

The  saliva  ejector  is  ])ut  into  the  patient's  mouth.  Small 
pieces  of  tem])orary  stoj)})ing  ai'e  softened  and  formed  into 
cones.  The  cavities  in  the  teeth  are  lubricated  with  eucalyptol 
compound  and  a  ])iece  of  the  soft  cone-shaped  stopping  is  put 
into  each  tooth. 

Staples  of  round  Cerman  silver  wii-e  of  suita])le  thickness, 
18-  and  2()-gauge,  respectively,  are  now  held  in  the  (lame  and 
when  siifficiciitlx-  licatctl  ai'c  allowed  io  eiiihed  Iheinselves  into 
first  llic  Icl'l  cii-itid  and  lali'i'al,  IIhmi  IIic  \r\'{  |;itei'al  and  lefl 
central,  llien  llie  Icl'l  (•<-n1ral  and  llie  riglil  cenli'al,  llien  llie 
rigid  cenli'al  and  ri;;lil   lateral  and  liiialK    the  I'liilit  lalei-al  and 


Sl'LIXTIXC    J.OOSK    TKK'I'll     WITH     I X  LAYS  235 

]iglit  cuspid.  It  will  be  noticed  that  all  ))ut  the  two  cusi)id 
teetli  carry  a  double  staple.  Witli  a  heated  ball  burnisher  of 
suLtal)le  size  the  staples  are  ur^ed  <leeply  into  the  temporary 
stopi)in<;-  and  as  a  final  coverin<;-  one  piece  of  sto])pino-  of  suffi- 
cient len^tli  is  softened,  curved,  and  i)acked  into  the  cavities 
against  the  staples  contained  in  them.  AVitli  proper  plastic  in- 
struments the  improvised  splint  is  tinished  and  finally  made 
smooth  with  a  ])it  of  cotton  di])ped  into  eucalyptol  compound, 
and  the  patient  is  dismissed. 


CHAPTER  XVIII 

EXTENSIVE  RESTOIJATIOXS  OF   (JCCLUSAL 
BALANCE  BY  MEANS  OF  GOLD  INLAYS 

Patients  liave  come  into  my  care,  tlie  occlusal  and  proximal 
surfaces  of  whose  teeth  have  been  badly  mutilated,  sometimes 
because  of  very  extensive  and  very  poorly  executed  amalgam 
fillings,  and  often  because  of  marked  attrition. 

Where  the  destruction- is  obviously  a  result  of  poor  dental 
ANork,  the  procedure,  though  tedious  enough,  is  comparatively 
simple. 

Study  models  are  obtained  and  record  models  may  be  made 
from  these  as  described,  or  separate  imin-essions  may  be  taken 
for  the  puri^ose  of  making  record  models. 

These  impressions  should  be  taken  in  plaster  of  Paris,  and 
should  be  removed  from  the  mouth  with  great  care,  because  of 
the  necessity  of  having  an  exact  reproduction  of  conditions  as 
they  exist  in  the  mouth. 

The  teeth  requiring  restoration  are  uiai-k'ed  off  on  a  chart, 
and  these  marks  are  duplicated  upon  tlie  study  models. 

The  jiatient  is  carefully  examined  as  to  age,  as  to  any 
jjeculiarity  or  abnormality  which  may  exist  in  the  mouth,  the 
condition  of  the  gingiva^  is  carefully  not(  d.  The  necks  of  the 
teeth  are  examined  with  ininuto  care,  and  the  occlusion  is  noted 
as  noi-mal  or  malocclusion. 

The  information  is  elicited  I'rom  the  ])ati('nt  as  to  which 
side  is  usually  used  for  mastication;  wliai  Food  is  usually  pre- 
feiTed,  and  how  inucli  lime  is  given  to  ineals. 

The  mouth  is  careful ly  (examined  in  the  periapical  region, 
and  all  iiifonnation  obtained  is  I'ccordcd  for  reference. 

''I'lic  |)a1i('n1  nia>'  he  dismissed  and  llic  siudy  of  the  models 
begun. 

Each  ino<lel  is  carefully  examined  by  itself,  and  each  tooth 
upon  the  model,  i)reviously  mai'ked  as   lecpiiring  attention,  is 

23G 


EXTKXSIVK    1:KST()I;ATI().\'S    ()[•"    OCCI.rSAI.    BAI.AXCK  237 

again  exaiiiiiu'd.  'riic  cavities  may  be  oulliiied  as  suggested 
lieretofore,  or  tlic  paits  i(Miuiriii,i;-  allciilioii  may  l)e  painted  in 
black. 

AVlu'ii  the  cxamiiiatioii  of  botli  models  is  comijleted,  they 
are  ])rouglit  into  occlusal  relation  with  each  otlier,  and  the  ex- 
tent of  tlie  parts  lacking  ni)on  their  occlusal  surfaces  must  be 
carefully  noted. 

The  least  nuitilated  of  the  posterior  teeth  is  now  looked 
for,  and  when  found  it  is  marked  with  the  letter  P,  indicating 
that  of  all  the  posterior  teetli  upon  tliese  models,  it  is  the  most 
nearly  ])eii'e<'t.    ■ 

The  man  who  has  diligently  nn^morized  tlie  directions  of 
stress  ui)on  or  against  the  different  teeth  will  not  need  to  make 


Fig.  192. — A  case  of  extensive  restoration.  Occluded  study  models  of  the  ease. 
Note  the  enormous  amount  of  attrition,  the  lack  of  space  between  lower  teeth  and 
upper  ridge,  the  involvement  of  all  the  gingivfP. 

the  step  now  desci'ihed,  although  I  consider  it  an  advantage  to 
do  so  in  every  case. 

Each  model  is  ])lace(l  u])on  a  heavy  sheet  of  drawing  paper, 
and  its  outline  is  trac<'d  u])on  the  sheet  in  ])en  and  ink  or  in- 
delible pencil. 

The  location  of  each  tooth  is  now  designated  upon  the  sheet 
by  drawing  a  mesial  line  downward  between  the  centrals,  until 
the  pen  or  pencil  strikes  the  paper  and  records  the  mesial  line 
of  the  outline  of  the  model. 

Next,  a  line  is  drawn  between  the  central  and  lateral,  on 
either  side  of  the  model  down  and  onto  the  paper,  then  lateral 


238  CAST    i;()LL)    A.ND    ronCELAl^'     IXLAVS 

and  cuspid,  etc.,  until  tlic  location  or  ratlier,  niesio-distal  ex- 
tent of  each  tooth,  has  been  recorded. 

With  a  pair  of  comi^asses,  the  thickest  portion  of  the  model 
is  measured,  a  record  is  made,  and  then  the  width  from  the 
buccal  surface  of  the  last  tooth  on  one  side,  to  the  buccal  sur- 
face of  the  last  tooth  on  the  opposite  side  is  noted. 

The  Avidtli  from  tooth  to  tooth  is  now  siibstracted  from  the 
previously  obtained  figure,  and  half  of  the  remainder  is  marked 
off  the  outline  of  the  model  on  each  side. 

Example:      Outline  at  widest  point,  50  mm. 

Width  from  buccal  surface  of  last  E.M.  to  last  L.M.,  40  mm. 


Ditt'crence  between  width  from  tooth  to  tooth  and  width  of  model,  10  mm. 
wliich  would  mean  the  marking  off  of  5  mm.  on  the  inside  of  each  margin  of  the 
outline  of  the  model. 

The  measurement  from  the  distal  surface  of  the  right  cus- 
jjid,  to  the  distal  surface  of  the  left  cuspid,  taken  from  the 
model,  is  compared  to  the  model  at  that  point;  the  subtraction 
is  made,  the  result  divided  in  half,  and  the  sum  of  each  half  is 
marked  off  upon  the  outline  on  the  paper.' 

A  i^erpendicular  is  now  dropped  from  the  point  recording 
the  median  line  of  the  model  to  a  line  connecting  the  two  points, 
marking  the  width  from  right  molar  to  left  molar.  (See  Figs. 
136  and  137.) 

A  line  on  each  side  is  drawn  from  cusjDid  to  molar,  and  a 
line  from  cuspid  to  median  point;  this  Avill  result  in  a  diagram 
equal  in  extent  to  the  outside  measurement  of  the  teeth. 

T]\('  widtli  of  molars  and  bicuspids,  bucco-lingually,  and 
cuspids,  labio-lingually,  is  now  taken  Avith  a  compass,  and 
marked  oif  on  the  paper.  From  the  points  upon  the  paper, 
which  have  marked  the  mesio-distal  extent  of  each  tooth,  lines 
ai'c  diawn  through  the  diagram  showing  the  location  of  the 
teeth.  This  will  result  in  a  series  of  (|uadrangular  (igures,  rep- 
]-esenting  the  teeth  in  the  model.  This  procedure  holds  for 
both  upper  and  lower  models. 

A\'i1li  tlic  aid  of  the  chart  giving  the  direction  of  stress, 
these  <lii'ections  ai-e  located  u])on  ibc  sheet,  and  liilh'  ai-rows 
ai-e  placed  to  indicate  the  directions, 

Where  the  stress  is  luarked,  the  an-ows  aic  (loubh'd;  that 
is,  1h(']-e  ai'c  Iwo  heads  to  the  ai'row;  llie  direction  in  wliicli  the 


EXTKXSIVK    KKSTOKA'I'IOXS    OF    OCCU'SAL    ]!ALAX('E  239 

stress  is  wcakci-  is  iiidicalcd  by  a  siii,i!,l('  licadc*!  ai  row,  and  the 
weakest  ])oiiit  of  sli'css  is  indicated  l)y  an  airow  sliowing  only 
one  line  at  llic  head.  Mai'k'cd  inl'i-a  sti-ess  is  hest  indicated  by 
a  l)lack  mark  in  the  center  of  the  li,i;nre  denotin*;-  tlie  par- 
ticukir  tooth.  And  the  (|uadi-aii,L;idar  li,i;iii-e,  coi-i'esj)ondinfj;  to 
the  most  nearly  perfect  posterior  tooth,  is  marked  with  a  P 
to  indicate  its  location. 

We  shad,  n))on  coin))h'ti()n  of  these  dia,i;i'ains,  and  with  a 
history  of  the  case  hel'oi'e  ns,  he  in  a  position  to  int(dli<>('ntly 
take  lip  the  woik  of  restoration. 

If  the  nearly  ])erfect  tooth  is  an  upper  one,  then  restora- 
tion should  l)e<;in  with  the  lower  tooth,  occluding'  with  the  nearly 
])ei'fect  upi)er  on;',  and  if  the  nearly  jierfect  tooth  he  a  lower  one, 
then  the  jjrocess  is  reversed  and  the  u])])er  teeth  oecludinf;'  with 
it  are  restored  tirst. 

Each  one  of  the  teeth  in  the  human  mouth,  except  the 
two  upi^er  third  molars,  and  the  two  lower  central  incisors, 
enter  into  occlusal  relations  with  two  opposing  teeth,  and 
broadl}^  speaking,  three  teeth,  two  uppers  and  one  lower,  may 
be  considered  as  an  illustration  of  a  lever,  one  upper  tooth 
representing  the  2)ower  arm,  one  the  weight,  and  the  lower  tooth 
the  fulcrum.  As  a  matter  of  illustration,  the  reverse  of  this 
proposition  holds  good;  that  is,  two  lower  teeth  form,  respec- 
tively, the  power  and  weight  arm,  and  the  upper  tooth  the  ful- 
crum. AVhen  all  parts  entering  this  relation  in  trinity,  are 
functioning  ])hysiologically,  we  may  consider  occlusal  balance 
as  present. 

AVlien  the  teeth  which  enter  into  occlusal  relation  with  the 
nearly  perfect  one  have  been  restored,  we  shall  have  an  occlusal 
guide  to  assist  us  in  bringing  about  occlusal  balance  in  the  en- 
tire mouth.  It  will  be  best  to  cut  the  cavities  in  the  teeth  upon 
the  models  with  small  chisels,  such  as  are  used  by  sculptors  or 
engravers.  AVe  shall  try  as  nearly  as  possil)le  to  dui^licate  the 
ideal  line  and  margins  and  ])lanes  upon  tlu;'  natural  teeth,  as  we 
have  cut  them  into  the  plaster. 

This  is  not  nearly  so  hard  as  it  would  seem;  in  fact,  it 
will  prove  much  easier  than  most  students  would  be  ready  to 
believe.  The  reason  too,  is  cpiite  simple  and  here  explained: 
If  we  had  omitted  taking  impressions  for  study  models,  and 


240  CAST    COLD    AXP    TOltCELAlX    IXLAYS 

making  our  diagram  of  .stress,  and  omitted  tlie  outlining  of  the 
cavities  ui)on  tlie  models,  and  of  cutting  these  cavities  iiito  the 
models;  if  ^ve  had  omitted  noting  the  most  nearly  perfect  tooth, 
and  Iiad  attacked  the  case  in  liand  witliout  study,  hajDliazardly, 
it  is  not  only  likely  but  quite  ai)i)arent,  that  the  very  extent 
of  the  task  would  have  bewildered  most  of  us  and  our  anxiety 
to  bi-jng  some  oi'der  out  of  chaos  would  have  made  us  overlook 
the  tine  and  most  essential  points  in  cavity  preparation.  All  of 
this  work  of  study  of  the  models,  and  stress,  the  making  of  the 
diagram,  the  taking  of  the  history,  etc.,  has  consumed  hours, 
and  made  us  familiar  with  the  case.  If  we  omit  this,  the  case 
is  strange  to  us,  and  we  are  strange  to  the  case.  The  difficulty 
is  added  that  we  are  dealing  with  live  tissues,  and  Ave  are  nnde- 
cided  just  how  extensively  to  cut;  in  other  words,  Ave  do  not 
know  exactly  what  to  do.  But  if  we  liave  made  the  careful 
study,  as  outlined  here,  and  if  Ave  have  cut  the  caAdties  into  these 
teeth  as  our  knowledge  of  stress  conditions  and  innnunity  areas, 
etc.,  t(dl  us  Ave  must;  and  if  Ave  liaA^e  j^lanned  our  restorations 
upon  the  models  in  accordance  with  the  requirements  of  occlu- 
sion, and  phonetics,  and  harmony  and  proportion,  and  l)eauty, 
then  we  know  exactly  Avhat  Ave  Avisli  to  do,  and  the  patient  pre- 
senting, Ave  j)roceed  to  do  just  that  thing. 

It  is  true,  Ave  may  ix'  liam])ereil  and  interfered  with  l)y  con- 
ditions in  the  moutli  wliicli  do  not  exist  on  the  models,  but  A\'e 
bear  in  mind  our  I'esult  on  the  model,  and  Ave  try  to  duplicate  it 
in  the  teeth,  removing  the  obstacle  as  it  presents  itself.  In  this 
way,  the  i-csull  of  our  woi'k-  is  more  nearly  likely  to  approach 
our  ideal  of  our  task-. 

It  is  (|nil('  a  dinVrcnt  mattei'  to  cut  into  live  tooth  struc- 
ture than  i1  is  1o  cut  into  models,  and  often  the  ideal  is  A^ery 
difficiiH  1o  cjiii-y  out,  hut  that  is  only  anotlici-  reason  that  the 
operator  shonhl  a|)])roach  the  ])ati('nt  oni\'  after  a  coni])lete 
and  exhaustive  study  of  the  case,  and  with  a  thorough  knowl- 
edge as  to  Avhat  he  wishes  to  do  to  each  particular  and  individ- 
ual tooth,  remembering  alwa.vs  that  the  ultimate  to  l)e  desii'cd 
is  hai'inonv  and  balaiKM'  in  the  i-(  Intioii  oT  the  tissnes  |)i-eseiit  in 
tlu'  oial  ea\ity. 

If  no  ])ain  oi"  put  I'eseeiit   eondition   be   picsent    to  wv'j;^  the 
ojxM-alor's  attention   and  sei'viee  to  any   i)ai-tieular  tooth,   it    is 


lox'iM'iXSix'i':  i;i';s'r(ii!A'ii().\s  oi'  occu'sai.  uai.axck  1^41 

Ix'st  to  <fi;()  lo  llic  one  aiitci'lofly  next  to  tlic  nearly  j)('i'r('ct  oiio, 
and  restore  that  to  aiiatoiiiic  and  ])liysiolo<;'i('  halancc;  tlien  tlio 
one  postei'ioi'ly  next  to  the  nearly  jx-i'leet  one  is  tak'cn  eai'c  of, 
and  thii'd,  the  nearly  perfect  one  ('onies  in  Tor  attention.  In 
this  way  we  lia\'e  made  nse  of  the  nearly  perfect  tooth  as  a 
^'uide  tlirou,L:,iiont  the  work.  It  has  determined  t'oi-  ns  the  mesial 
extent  of  the  tooth  )tostei-ioi-|y  to  it,  and  the  distal  extent  of  the 
tooth  anterioily  to  it.  it  has  (htei-mined  for  us  the  occlusal 
surfaces  of  the  two  teeth  with  which  it  occludes,  and  now  all  of 
the  teeth  that  liaxc  been  restoi'ed  sei've  as  a  ^uide  for  correct 
r(  stoi'ation,  as  re<;ards  mesio-distal  diauieter  and  occlusal  sur- 
face of  the  nearly  ])ei'fect  or^'an. 

All  this  is  nothing'  else  l)ut  a  recognition  of  the  interde])end- 
ence  of  all  media  which  enter  into  inse])aral)le  relations  with 
one  anotlier  to  create  a  ])erfect  oi-<;an  of  incision,  ])rehension, 
trituration  and  articulation. 

Doimj,'  the  work  in  the  manner  desci-ilxd,  we  shall  have  the 
adva.nta.G,e  of  incapacitating;-  the  ])atient  on  one  side  of  the  mouth 
only,  and  thus  the  primary  jjrocesses  of  nutrition  will  not  be 
interfered  with,  and  we  shall  have  our  patient  more  trancpiilly 
submissive  to  our  ministrations,  which  is  a  factor  conducive  to 
imich  better  results  than  a  ])atient  nervously  tensioned  to  a 
high  ij.itch  and  querulous  o])])osition. 

AVhen  one  side  from  molars  to  incisors,  u])per  and  lower, 
has  been  restored,  the  other  side  is  taken  hold  of  and  treated 
in  mucli  the  same  maimer  uidil  it  is  completed.  When  the 
case  is  tinished,  two  ])laster  im])ressions  are  ol)taine(l  and  models 
made.  The  record  models  are  marked  with  the  patient's  name, 
the  date,  and  VV.i)/.,  standing  for  record  model.  The  study 
models  are  marked  *S'.21/.,  and  the  last  models  are  marked  F.M., 
for  finished  models,  and  the  date  of  completion  of  the  same  All 
models  ai'e,  of  course,  to  l)ear  the  name  of  the  patient. 

AVhen  the  loss  of  l)alance  in  mastication  is  due  to  other 
causes  than  jooor  dental  work,  the  procedure  of  restoration  is 
markedly  different,  and  there  is  considerably  more  involved. 

AVe  shall  not  consider  the  cases  coming  under  heading  of 
traumatic  oi-igin,  because  in  one  way  or  another  they  ma^^  be 
handled  l)y  the  means  already  described,  or  as  yet  to  be  de- 
scril)ed.    It  would  be  a  waste  of  time  to  devote  a  sjiecial  chap- 


242  CAST    GOLD    AXI)    POIU'KLAIX    INLAYS 

tor  to  restoration  l)y  means  ol:'  inlays  of  teetli  tranniatieally 
injured. 

Since  eaeli  injury  would  2jro1)al)ly  dilfer  from  every  other, 
the  ease  would,  of  course,  present  a  different  history,  and  the 
extent  of  the  injury  varyinr;-,  the  treatment  would  necessarily 
clian<;e.  AVitli  all  that,  these  cases  are  subject  to  tile  same 
rules,  and  should  be  studied  quite  as  carefully,  if  not  more  so, 
than  the  ones  broken  down  by  poor  workmanshi]). 

So  we  shall  take  in  the  extensive  cases  of  traumatic  origin, 
under  the  heading  of  those  to  be  considered  as  l)eing  due  to 
attrition,  in  reference  to  teeth. 

Attrition  is  the  act  of  weariiig  down  the  teeth  l)y  mastica- 
tion, because: 

First:     The  patient  may  have  an  end-to-end  malocclusion. 

Second:  The  greatest  number  of  i)osterior  teeth  may  have 
been  lost  in  early  life,  and  the  entire  stress  of  mastication  is 
thrown  onto  the  remaining  anteriors;  which  stress  they  can  not 
resist,  and  hence  are  worn  down  bj"  attrition,  or 

Third:  The  osseous  system  of  the  i^atient  is  out  of  har- 
mony in  development  and  calcification  (hence  resistance),  with 
the  muscular  structure  of  the  same  patient.  In  other  words, 
there  is  a  predisposition  in  this  j^artieular  case,  a  sort  of  phys- 
ical constitutional  inferiority,  osseously  speaking,  or  a  sort  of 
pln^sical  constitutional  superiority^,  muscularly  considered,  as 
you  please. 

AVliere  the  cases  are  most  extensive,  and  involve  the  entire 
masticatory  apparatus,  and  they  usually  do,  the  treatment  is 
miicli  the  same. 

These  cases  are  usually  between  thirty-hve  and  fifty-five 
yeai'S  of  age.  T>y  this  T  mean  that  they  are  usually  thirty-five 
to  fifty-five  years  old  when  tliey  seek  relief. 

These  cases  ai'c  so  (^\tensi\-e,  and  the  treatment  so  iiiv()l\-ed, 
and  so  much  depends  upon  a  favora))le  prognosis,  that  no 
amount  of  care  gixcn  to  tliese  i-estorations  can  be  said  to  be  too 
nmeji.  T\\('  ti-eatmeiit  is,  with  the  gi'oatest  caic,  (juite  a  sti'ain 
U])Oii  the  ])atieiit's  uerN'ous  system,  and  lor  this  reason,  if  I'oi" 
no  otliei-,  the  ])atient  should  he  dire('1e<|  to  consult  a  cai-efnl 
internist,  a  diagnostician  of  the  liist  rank',  and  a  i-e|)oi't  should 
be  obtained  from  him  as  to  tiie  genei'al  condition  of  the  j)atieiit. 


KX'I'KXSINl';    IMvSTOilA'l'lOXS    Ol'    OCCl.rSAI.    IJAI.AXCE  243 

'^I'o  a  lar.nc  cxlciit  the  |)i-(),i;i-('ss  oF  tlic  dciit.-il  work  will  de- 
pend u))()ii  tlic  i-('|)()i-t  liaiidcMl  ill  ))y  the  |)liysi('iaii.  IT  llio  ^■en- 
eral  condition  of  the  paticiil  is  such  that  lie  can  witiislaiid  Hie 
stress  of  prol  I'actcd  denial  operations,  a  Ni^oi-ons  pi-o,i;rani  may 
])e  pni'sued  and  the  woiU  linishiMl  in  a  inm-h  shoi'tei-  time  than 
if  the  re|)ort  ahout  his  ^I'nei-al  condition  were  to  noetssitate 
careful  ft'uardin^-  a^i^'ainst  the  least  shock  to  the  nervous  system. 

It  is  wise  to  always  ))ear  in  mind  that  these  patients  liave, 
by  virtue  of  tlie  very  condition  winch  ))rinf>,s  tliem  to  us,  received 
an  im|)ulse  which  started  them  <lo\\ii  hill  on  the  road  of  health, 
and  that  theii'  proi;i-(  ss  in  that  direction  must  he  checked  ^-(Mitly, 
but  etiliciently. 

Usually  these  cases  are  coin])licated  by  jx'ridental  iri-itation, 
or  even  active  suppuiation  in  the  jxM-ideiital  re<i,'ion. 

The  f^ino'iva'  are  swollen,  congested,  l)leed  readily,  and  mas- 
tication is  painful;  a  hypertropliy  of  tlie  alveolar  structure  of 
the  mandible  and  suj^erior  maxilhr  may  be  present. 

The  muscular  structuiv  of  tlie  tem])oro-maxillary  articula- 
tion will  be  found  overdeveloped,  if  at  all  out  of  the  ordinary. 
The  mandil)le  is  found  freely  movable  in  a  laterorotary  direc- 
tion. There  is  usually  present  a  variation  in  the  length  of  the 
l)osterior  teetli,  the  u])per  ones  l)eing  shorter  than  the  lower 
ones,  due,  no  doubt,  to  the  fixed  position  of  the  superior  maxilhr 
and  the  more  or  less  complete  passivity  of  the  teeth. 

Very  little,  if  any,  enamel  is  |)resent  ujjon  the  occlusal 
surfaces  of  the  i:)Osterior  teeth,  and  the  incisal  portions  of  the 
anteriors  are  altogether  devoid  of  it.  The  exposed  dentine  of 
the  anteriors  j^resents  a  liighly^polished  apjxuirance,  while  the 
occlusal  surfaces  of  the  posteriors  present  either  an  unevenly 
smooth  surface,  or  a  number  of  grooves  and  pits  corresponding 
in  location  to  the  normally  existing  fissures  and  sulci  in  these 
teeth.  Most  of  these  cases  will  exhibit  a  reddish  stain  on  the 
occlusal  surfaces.     Knife-edged  occlusal  margins  are  the  rule. 

Regardless  of  the  fact  that  the  naso-mental  line  has  been 
gradually  shortened  during  the  years  in  wliicli  this  j^i'ocess  of 
attrition  has  been  going  on,  we  shall  find  the  masseter,  and  tem- 
poral, as  well  as  buccinater  muscles,  tense  and  thickened,  ])r()l»- 
ably  congested. 

We  shall  ]n-obab]y  tiiid  these  ])atients  to  l)e  introspective 


244  CAST    COLD    AXl)    PORCELAIX    IXLAYS 

to  the  point  ot"  iiiclaiicliolia,  iiiicoimmiiiicaliNH',  ami  ol'ton  eva- 
sivo  ill  aiisweriii«4'  (juestioiis,  difficult  to  eiitlmso,  and  tliey  are 
ajDt  to  confuse  tecliiiieal  information  given  to  tlieni  as  the  work 
progresses. 

They  are  often  inita])U\,  always  fidgety,  and  their  fingers 
are  usually  busy  doing  something,  if  only  playing  against  each 
other.  They  are  most  often  careless  in  their  manner  of  dress, 
and  usually  sim])k'  in  their  food  requirements. 

From  several  of  these  eases  which  came  under  my  observa- 
tion and  care,  ciuestioning  elicited  the  information  that  they  as 
a  rule,  shunned  the  op])osite  sex.  The  foregoing,  plus  the  diag- 
nostician's report,  will  give  a  rather  comprehensive  picture  and 
history  of  these  patients. 

If  all  the  facial  lines  and  features  of  such  a  patient  are 
normal,  and  in  geometric  harmony,  the  deduction  that  the  masti- 
catory ajiparatus  was  in  proper  proportion  l)efore  it  suffered 
from  the  attrition  is  i^ermissible,  and  the  other  features  will  fur- 
nish the  means  of  determining  the  extent  to  which  this  process 
lias  advanced. 

Any  photograph  the  patient  may  have  had  taken  years 
jorior  to  his  visit  for  relief,  would  also  l)e  of  service  in  this 
respect. 

If  the  teeth  are  still  in  ])roper  mesio-distal  relation  to  one 
another,  only  the  occlusal  third  has  been  partially  or  totally 
obliterated. 

If  all  mesio-distal  relations  of  the  teeth  have  been  de- 
stroyed, and  W  the  features  of  the  patient,  such  as  fronto- 
orbital,  and  oi'bito-nasal  lines  be  une(|nal  to  any  great  extent, 
then  the  ■deduction  that  the  masticatory  a])])aratus  was  out  of 
harmony  with  Ihc  i-est  of  the  Features,  even  before  attrition  be- 
gan to  weai-  the  teclli  down  is  ])eiiiiissi])le.  The  bulk  to  be 
added  to  the  tcclh  hcconics  a  inattei-  ol'  iiieasurenient  of  the 
various  features  and  expei-inientation.  \\'liiclie\(  )•  is  the  case, 
urgent  nee(|  o)'  Ihe  present  is  to  first  restore  the  gingival  and 
jjeri<|ental  area  1o  a  physiologic  condition,  lake  care  of  any  root 
canal  work'  which  iiia_\'  he  liecessary,  and  then  o|)en  the  bite  ])y 
means  of  a  S])lin1,  to  an  exteiil  a1  least  doiilile  that  which  seems 
to  l)e  necessr.:'y. 

'^riie  patient  must   wear  this  splint    incessant  !>■   for  al  least 


KX'I'MXSIN'I';    IMOS'l'OIIA'l'lOXS    (»l'    OCCLI'SAI.    I'.ALAXCE  '24^) 

llircc  (lays,  'riiis  iimsl  he  insisted  upon,  and  in  (jrdcr  to  help 
the  j)atieid  onci'  his  1i-yin,i;'  time,  lie  must  he  k(=j)t  vci'V  l)iisy 
(lui-in,i;-  tlu'  da>\  must  lia\-e  sleep  a1  ni,i;ld,  e\-en  if  tlie  sleej)  is 
to  be  indiiccMl  hy  liyjjuot  ics.  If  tlie  lath  |-  ai'e  employe(|,  tliev 
are  followed  by  tlie  use  of  laxatixcs. 

After  three  days  the  ])atieid  is  allowed  to  remove  the  sjjlint 
durini;-  meal  time. 

The  strictest  liy<;ienic  ])reeautioiis  are  employed  in  kee])in,^- 
the  mouth  clean,  and  no  deviation  from  the  prescribed  regime 
is  ])ermitted. 

It  must  be  ivniemhered  that  this  is  a  i'e-creati\-e  \\()i-k  that 
is  g'oini;'  on,  and  that  the  operator  is,  if  he  has  the  necessary 
intelligence,  in  truth  a  creator  of  a  real  ])i-iniary  factor  in  the 
human  economy.  The  i)atient  must  be  made  to  realize  this  for 
his  or  her  own  ultimate  good. 

Xever  l)efore,  in  the  liistory  of  human  error,  has  it  been 
I^ossible  to  so  utterly  wipe  out  every  evidence  of  this  dental 
shortcoming  as  it  is  today.  It  is  very  likely  that  even  the  minds 
that  conceived  this  entire  process  of  cast  gold  inlays,  never  fully 
realized  the  extent  of  the  blessings  tlie  process  might  bring  and 
but  for  this  process  our  work  in  these  cases  would  l)e  today  as 
it  has  l)een  in  the  ])ast — nothing  l)ut  a  ])0()r  i)a.lliative  effort,  full 
of  nothing  so  nmch  as  futility. 

CONSTRUCTION  OF  THE  SPLINT 

Plaster  iin])r(  ssions  are  obtained  from  the  ui)per  and  lower 
jaw,  and  models  are  made.  Three  layers  of  number  .001  tin  foil 
are  burnished  over  the  upper  model,  taking  in  the  crowns  of  the 
posterior  te(  th  and  extending  u])  to  the  gingi^•al  surface  of  them 
and  beyond,  and  as  far  back  toward  Hie  ])alate  as  a  i)late  made 
for  the  case  would  be  allowed  to  go. 

All  of  the  i)alatal  surface  of  the  foil,  as  well  as  the  p)art 
covering  half  of  the  ])alatal  surfaces  of  the  teeth,  is  covered 
with  a  sheet  of  basejilate  wax  of  medium  thickness. 

The  balance  of  the  palatine  surfaces  of  the  teeth  and  the 
occlusal  surface  upon  the  four  posterior  teeth  is  covered  with 
three  or  four  layers  of  the  same  base])late  wax  and  the  buccal 
surface  of  the  Toil  upon  the  posterior  teeth  is  coated  with  one 


246  CAST    (lOIJ)    AXL)    roiICELAIX    IXJAYS 

layer  of  llic  A\ax,  wliidi  lixyev  is  to  reach  over  and  onto,  and 
be  melted  into,  llie  three  or  J'onr  layers  of  the  occlusal  waxes. 
Tliis  wax  must  he  niari;iually  melted  onto  the  foil,  so  that 
A\lieii  the  foi-mer  is  removed  from  the  model,  the  foil  will  come 
with   it. 

The  wax  is  trimmed  to  jn'oper  outline,  and  a  suri)lus  of  foil 
is  allowed  to  remain,  wliich  may  be  folded  back  on  the  Avax. 
This  contrivance  is  chilled  in  ice  water,  and  placed  in  the  pa- 
tient's mouth  for  determination  as  to  occlusal  thickness.  It  is 
removed  and  replaced  upon  the  model,  a  layer  of  soft  wax  is 
])hice(l  upon  the  occlusal  surface  and  melted  onto  it,  so  that  we 
sliall  have  a  layer  of  wax  ujjon  tliat  surface  about  one-half 
inch  thick.  The  jDlate  is  again  inserted  into  the  mouth,  and  the 
patient  is  admonished  to  swallow  and  close  the  teeth.  The  re- 
sulting- impression  of  the  loAver  teeth  on  the  wax  will  furnish 
the  necessary  guitle  to  place  the  lower  model  into  projjer 
l^osition. 

This  is  done,  and  two  jjieces  of  wood,  reaching  across  from 
model  to  model,  are  waxed  onto  each  model,  and  the};^  are  placed 
in  the  anatomic  articulator.  AVhen  the  plaster  has  set,  the  ad- 
justment screw  is  fixed,  the  surplus  of  the  plaster  is  trinuned 
off,  the  two  pieces  of  wood  are  removed,  the  articulator  opened, 
and  tiie  wax  and  tin  foil  are  carefully  removed  and  laid  aside. 

A  careful  preliminary  study  of  the  models  should  now  take 
])lac(';  undercuts  which  may  interfere  Avith  the  placing  of  the 
sjjlint  should  be  filled  up,  or  otherwise  obliterated. 

The  lower  model  is  covered  with  a  layer  of  tin  foil,  the 
ai-ticulator  is  close<l,  and  the  space  between  the  models  is  grad- 
ually reduced  until  tli<-\  meet.  Tn  this  position  they  should  be 
viewed  from  every  angle;  the  size  of  the  teeth  is  carefully  noted 
as  regards  circumference,  and  the  models  are  sej^arated  to  al- 
low i'oi'  a  height  of  tooth  in  pi-opoilion  to  this  circumference. 
It  must  l)c  home  in  mind  that  these  approximate  measui'ements 
must  be  double,  siuee  \\  r  ha^('  hotli  models  u])on  the  IVame. 
Ila\iii.i;-  opened  tlie  articulator  to  ahoiit  the  extent  recpiii'ed,  we 
sim|)l\'  open  it  again  as  much,  so  that  il'  'ir,  of  an  inch  he  miss- 
ing olT  the  lower  teeth,  and  '/ic,  to  '/•;-  off  the  up])er  teeth,  we 
would  lia\'e  (tpened  the  articulator  'm-,  '  k;  and  ':'■,-  !  Vic  i 
Vic.  -■•    l::-^,  or  -"'k;  oI'  an  inch,      in  this  condition,  the  articulator 


KXTKXSIVK    ItKSTOItA'I'IOXS    Ol'    orcMSAI.    nAIAXCK 


1^4" 


is  lixcd  so  Hull    the  sjjacc  iiia\-   not    accidentally   he  rcMluccd  or 
raised. 

Tlicrc  is  a  uood  sound  ix'asoii  i'oi  opening;'  llio  articulator 
to  (loul)l("  the  extent  whicli  tlie  attrilional  wear  calls  for  and 
that  is  that  It  will  lead  to  a  inusculai'  adjustment  in  the  leni])oi-o- 


Fig.    108. 


Fig.   194. 


Fig.  193. — A  viow  of  a  splint  made  for  a  case  of  extensive  restoration. 

Fig.  194. — Another  view  of  tlie  same  splint  which,  when  it  was  first  made  and 
worn,  covered  all  the  anterior  portion  of  the  jaw,  as  well  as  the  part  now  occu- 
pied by  it. 


Fig.   195. 

Fig.  193. — The  ^jiliiit  in  position  on  the  model.  Note  the  amonnt  of  space 
created  between  npjier  and  lower  teeth;  twice  as  nuich  as  is  really  needed,  for  reasons 
explained   elsewhere. 


niandibular  articulation,  far  Ijeyond  tliat  necessary  for  simple 
toleration  of  tlie  work  when  completed,  and  so  tlie  comi^leted 
work  bein^-  much  lower,  <;ingivo-occlnsally,  than  the  si^lint,  the 
sensation  the  ])atient   will  experience  njion  removal  of  sj^lint 


248  CAST  coij)  Axn  porcelain  inlays 

and  insertion  of  tlic  work,  will  Ix'  ont'  ol*  ,i;roat  relief;  and  the 
nuiscles  havin^i;-  been  adjusted,  and  having'  become  more  or  less 
accustomed  to  the  additional  amount  of  stretcli  Avill  tind  an 
enjoyahle  relaxation  in  l)ein,i;-  i)ermitt((l  to  i\o\  into  a  much  less 
tense  jiosition.  The  tendency  of  too  great  and  lience  destructive 
nmscular  stress  upon  the  newly  j^laced  work,  Avill  in  this  manner 
be  wliolly  avoided. 

Tlie  wax  i)late  backed  or  lined  with  tin  foil  is  replaced  upon 
the  u])i)er  model,  tlie  wax  is  softened  somewhat,  and  a  close 
adaption  of  it  to  the  model  is  brought  al)0ut.  Enough  soft  wax 
is  added  to  the  occlusal  surface  to  take  up  the  space  created  by 
tlie  oi3ening  of  the  articulating  frames,  and  a  surjilus  is  added 
so  that  the  teeth  of  the  lower  model  may,  ujoon  tlie  closing  of  the 
articulator,  bury  themselves  in  the  soft  wax  upon  the  occlusal 
surface  of  the  splint. 

The  foil  present  u])on  the  lower  model  will  prevent  the 
sticking  of  it  to  the  Avax,  and  we  shall  have  a  more  or  less  accu- 
rate impression  of  the  lower  teeth,  as  a  guide  to  aid  in  carving 
uj)  tlie  occlusal  surface  of  the  splint. 

Tlie  external,  or  liuccal,  surfaces  of  the  wax  splint  must 
))e  allowed  to  reach  over  and  enclose  the  l)uccal  surfaces  of  the 
lower  i)osterior  teeth,  so  tliat  when  the  splint  is  duplicated  in 
vulcanite,  it  will,  win  n  worn  l)y  tlie  patient,  prevent  effectively, 
tii-st,  the  biting  of  tlie  soft  tissues,  and  scn-ond,  the  latero-rotary 
mot  ion  of  tbe  mandd)le. 

This  will  aid  in  the  hxation  of  tlic  muscles  and  com])el  the 
patient  to  exercise  a  more  ])roiiouiiced  iiili'a  ])ressnre  u])on  the 
teeth,  which  will  lia\-('  a  stimulating  oi'  I'atlier  toning  effect  u])on 
tlie  ])eridental  and  gingixal  tissues. 

In  carving  u])  the  occlusal  surfaces  of  llic  s|)liiii  in  flic  wax, 
llic  ;;iit('rior  l(M'tli,  uppci'  am!  lower  arc  Id't  IVcc  from  any  in- 
(Miiiibi'anc'',  ;in<l  Ihc  ciilirc  stress  is  llirowii  upon  tlic  ])()slei-ior 
Ici'l  h,  uj)])('r  and  lower. 

The  s])rnit  is  i-('uio\e(l  IVoni  llic  model,  llask'ed  and  xulcaii- 
i'/,e(l  ;ind  linislie(|  off,  w  lien  it  is  read)'  1o  insert  into  the  ))atieiil's 
mouth.  Al'tei-  lia\ing  been  worn  I'or  three  or  lour  days,  the  ex- 
ternal or  biieeal  oNeihaiigi iig  |)lates  ma\'  be  considera))ly  sliort- 
enecl,  oi-  even  remoNed.  ;ind  it  will  be  round  tliat  the  tendency 
for  too   free   ;i    hitei'al    niolion    will    li;i\e  diminished   to   a   great 


KXTKXSIVK    I;KS'I'()|;ATI().\S    of    OCCM'SAI.    I'.AI.AXCE  24!) 

(k'^i'cc;  il  will  slill  he  prcsciil,  l»iil  will  not  iiiaiiilVst  itscll'  luilil 
after  coiisidci-nhic  pi-cssiii-c  lins  Ix'cii  sjiciit  upon  the  Iccili  in  nn 
intra  tliriu'tion. 

Tlic  ])ati('iit  iniisl  wear  lliis  si)linl;  bill  il  may,  il'  so  desired, 
be  iviiioved  at  nical  lime  and  at  ni,i;bt,  altliou,L;li  it  may  be  worn 
by  the  jjaticiit  dni'ini;-  the  ni^lit  without  fear  of  inislia]),  if  il  lias 
been  carerully  const  fueled. 

Tlie  models  I'l-oni  wliicli,  or  u])on  wliieli,  the  s))rnd  \\as  made, 
are  kept  as  reeoi-d  models.  After  tlie  s|)liiit  has  been  worn  four 
da_\s  to  one  week',  plastei'  imj)i"essions  are  obtained  and  study 
models  are  made. 

The  models  ai'e  diai^i'ammed,  and  the  ehai'ts  of  stress  direc- 
tion ai'e  made.  The  models  are  ))i'()U,i;lit  into  occlusal  relation 
as  it  exists  in  the  mouth;  this  may  l)e  done  by  means  of  a  wax 
bite,  or  if  any  ])roiioiinced  landmai'ks  be  ])resent,  these  may  be 
used  as  a  <;iiide. 

Tlie  models  are  then  mounted  ujxjn  the  adjustable  articu- 
lating' frame,  the  cavities  may  now  l)e  outlined  and  even  formed 
in  the  plaster  casts,  kee])ini;-  in  mind  that  we  are  workino-  to 
restore  the  teeth  to  usefulness  and  anatomic  ])erfection,  and  to 
restore  to  orif2,inal  dimensions  the  naso-nn  ntal  line. 

If,  as  said  before,  the  rest  of  the  featui'es  are  in  harmony 
with  one  another,  the  conclusion  that  the  naso-mental  distance 
was  originally  normal  relative  to  these  features,  is  permissible, 
and  if  the  remaining  features  are  out  of  harmony  and  propor- 
tion, then  a  naso-mental  line  which  will  l)e  least  obtrusive  is 
Ijroduced.  The  average  measurements  for  the  normal  face,  as 
determined  by  sculptors  and  artists  for  the  past  ages,  give  the 
naso-mental  line  as  ^-'i  inches  long  and  llie  length  of  the  normal 
nose  as  l^s  of  an  inch.  Tlie  normal  upper  lij)  when  the  mouth 
is  closed  is  %  of  an  inch.  The  length  of  the  nose  is  ol)tained 
l)y  drawing  a  horizontal  line  througli  the  cent(  r  of  tlie  i)upils 
of  the  eyes  and  dr()j)i)ing  a  perpendicular  from  tliat  line  to  the 
tij)  of  the  nose. 

The  nornuU  face  from  the  center  of  the  i)upils  should  give 
the  diagrannnatic  reading  as  illustrated. 

The  naso-mental  line  of  the  patient  is  taken  and  noted  down 
on  the  articulator  and  i-ecord  and  study  models,  as  well  as  the 
Jiistory  chart.    It  will  naturally  Ije  found  that  the  length  of  the 


250  CAST    tiOLl)    AND    POUCELAIN    INLAYS 

line  varies  iiiverse1\'  witli  tlie  extent  to  Avliicli  tlie  ])ro('ess  of 
attrition  has  jorogressed,  that  is,  tlie  greater  tlie  attrition,  the 
shorter  the  line. 

For  the  i)nr])ose  of  lucid  ilhisti'atioii,  ^ve  \vill  assume  that 
the  naso-nieiital  line  of  the  patient  is  2%  inehes  long,  Avhich  in 
a  noi'iiial  featured  individual  is  V-i  inch  longer. 

The  articulating  frame  sujjporting  the  models  may  now  he 
opened  until  tlu^  models  are  M  inch  apart  occlusally,  and  the 
frame  may  l)e  hxed  in  this  position. 

This  would  be  a  fairly  accurate  manner  of  determining  the 
ultimate  amount  of  space  necessary  to  be  gained  in  order  to 
restore  the  lost  featural  balance,  but  for  the  restoration  of  oc- 
clusal balance  much  greater  care  is  required. 

Four  i^ieces  of  German  silver  plate,  3f)-gauge,  are  swaged 
up  to  cover  the  posterior  teeth  of  both  the  upper  and  lower 
models  down  to  one-half  of  their  length.  They  are  filed  and 
polished  so  as  to  present  smooth  surfaces  and  margins  to  the 
tongue  and  cheeks. 

The  occlusal  surfaces  are  roughened,  slightly  heated,  and 
covered  with  a  la^^er  of  Avax  /4  inch  thick,  each  piece  of  metal 
carrying  the  more  or  less  soft  wax  and  placed  into  its  respec- 
tive position  within  the  mouth.  A  hot  instrument  is  drawn 
across  each  wax  surface,  the  patient  is  directed  to  place  the 
tongue  upon  the  roof  of  the  mouth,  to  swallow  and  close  the 
mouth.  A  piece  of  hard  rubber  or  hard  wood  or  metal  /4  inch 
in  thickness  is  held  between  the  anterior  teeth,  to  prevent  too 
great  a  pressure  from  being  exercised  upon  the  Avax;  the  lat- 
ter is  chilled,  and  the  upper  and  lower  metal  j^latts  will  be 
found  to  adhere  through  the  medium  of  the  wax.  This  will 
really  produce  two  partial  splints  Avhicli  nmst  now  be  so  em- 
bedded in  a  refractoi'y  compound,  that  the  metallic  plates  will 
])e  immovably  held,  while  one  surface  of  the  wax  shall  be  ex- 
j)OSed  so  that  all  of  it  ma\'  l)e  removed  hy  l)oiling  the  i)iece  in 
wate]-. 

The  s|)ace  thus  j»rodu(*<'(l  hclwccn  the  two  plates  of  metal 
may  be  tilled  with  several  pieces  of  (ierman  silviM-  Avire,  the 
whole  of  it  fluxed  and  soldeied  with  tin  until  they  j)i-esent  a 
fairly  fidl  a])])eai"anee  and  sniooth  surface. 

'I'liese  metallic  plates  are  now  joined,  each  lowci'  to  its  cor- 


EXTENSIVE    ItKSTOHATIOXS    OK    ()('("!. ISAL    i;AI>AX('K  -!.)1 

responding'  Uj)j)('i"  section,  are  reinoN'ed  fi-oiii  tlie  investnienl 
conipoiind,  iinislied,  and  2)olislied  and  ])la('ed  into  the  mouth; 
the  i^atient  is  diiccled  to  close  the  nioutli,  and  it  will  he  found 
that  the  naso-mciital  line  is  now  2%  inches  lon,i;-  instead  of  2'/{. 
inches. 

Of  late  I  have  joined  these  ])lates  1)>-  \ulcani'/jn^'  ruhhei' 
between  and  onto  them,  in  which  case  the  occlusal  surfaces  of 
these  plates  nuist  he  c()nsi(leral)ly  roughened,  so  that  the  ruh- 
ber  will  adhere. 

The  parts  of  one  ])artial  splint  which  covers  the  tirst  upper 
and  lower  molars  and  the  second  bicuspids  are  cut  out  with 
a  bui-r  and  saw;  this  will  leave  one  partial  splint  tittiuft-  over 
the  last  molars  and  hrst  Incuspid. 

We  are  now  in  a  position  to  begin  the  reconstruction  of  the 
first  molars  and  the  second  bicuspids. 

If  the  teeth  are  still  in  normal  mesio-distal  relation,  then 
the  amount  of  building  up  to  be  done  is  easilj^  determined,  if 
we  consider  the  following:  From  the  gingival  line  up  toward 
the  occlusal  surface,  a  tooth  may  be  divided  into  three  parts 
horizontally,  which  will  give  a  gingival  third,  a  middle  third, 
and  an  occlusal  third. 

The  mesio-distal  relation  of  posterior  teeth  takes  place  at 
the  greatest  circumference  of  these  teeth,  and  the  greatest  cir- 
cumference of  these  teeth  is  invariably  to  be  found  at  the  gin- 
gival i^lane  of  the  occlusal  third. 

The  teeth  of  the  case  in  hand,  being  in  mesio-distal  relation, 
we  conclude  that  only  the  occlusal  third  or  less  has  been  de- 
stroyed ])y  attrition.  We  measure  the  remaining  portion  of  the 
teeth,  gingivo-occlusally,  divide  the  result  in  half,  and  we  know 
how  high  the  tooth  should  be  when  restored;  this  is,  of  course, 
to  be  done  before  any  cavity  j^reparation  is  attempted. 

If  the  mesio-distal  relation  of  the  teeth  has  been  lost  be- 
cause of  this  process  of  attrition  or  otherwise,  the  following 
rules  will  have  to  be  l)orne  in  mind  when  we  are  engaged  in  the 
correct  restoration  of  these  teeth. 

If  every  surface  of  a  molar,  except  the  occlusal  surface, 
be  ground  at  right  angles  to  the  gingival  ])lane  of  the  gingival 
third,  in  otliei-  words,  if  taking  the  circumference  of  the  gin- 
ival  plane   of  the   gingival  third   as   a   guide,   we   ground  the 


252 


CAST    COLD    AX  I)    PORCELAIN    INLAYS 


Fig.   196. 


Fkr.  197. 


Fio-.   19S. 


Fig.  199. 


EXTKXSIVH    KICSTOKATIOXS    OK    ()('( '1,1 'SA  F.    IJALAXCE  253 


Fij;'.  196. — All  occlu^iil  \\v\y  (if  tlic  ukmIcIs  of  tlio  same  caso, 
the  teriil)le  liavuc  wiouolit  by  iiogicct,  niisiiiKlcMstaiidinf;-,  aii<l 
poor  work  may  })0  more  plainly  seen.  Note  carefully  the  evidence 
of  marked  congestion  in  tk?  gingival  region  of  tlic  iniiiidihje.  All 
of  the  upper  and  lower  anterior.?,  cu.sj)i(ls  included,  were  puti;  s- 
cent. 

Fig.  lf)7. — The  model  of  the  upjier  tPeth  of  case  after  six 
months'  treatment.  The  roots  have  liceu  jilaccd  in  a  healthy 
condition  and  aic  carrying  cast  liase  crcjwns.  A  rcnnixalilc  liridge 
supplies  the  missing  teeth  on  the  right  side  of  tlie  mouth,  cuspid 
and  molar  serving  as  abutments. 

Fig.  IDS. — The  lower  mudLd  showing  c'early  the  rebuilding 
of  the  anteiior,  and  some  of  the  pesteri()r,  teeth  l)y  means  of  the 
cast   gold  iiday   and   cast  base  crowns. 

Fig.  199. — The  upper  and  lower  models  in  occ'usion.  Note 
the  increase  in  space  on  left  side  of  the  mouth,  for  which  the 
bridge  has  m)t  yet  bpen  made.  Note  the  difference  in  apiiearance 
of  the  gingival   areas. 


254  CAST    GOLD    AXD    PORCELAIN    INLAYS 

walls  of  the  tooth,  so  that  a  wire  iiieasiirenient  taken  around  the 
gingival  circnmferenee  will  j^ass  easily  up  and  down  npon  the 
teeth,  we  would  tind  that  the  highest  point  of  the  occlusal  emi- 
nences were  in  line  with  some  point  on  the  gingival  circumfer- 
ence. 


Fig.  200. — An  occlusal  view  of  a  finished  case  of  extensive  restoration  by 
means  of  cast  gold  inlays  and  two  upper  bridges.  All  lower  teeth  distally  to  the 
t-u.spids  have  been  restored  with  inlays.  The  anterior  teeth  have  been  Imilt  u})  with 
cast  base  porcelain  crowns. 


Fig.  201. — A  side  view  of  the  same  case — upper  and  lower  models  in  occlusion. 
Note  here  the  added  length  of  the  teeith  as  compared  with  the  models  before  work 
was  started.     The  longtli  of  the  iiaso-nieiital  lino  was  increased  %2  inch. 

Now  if  we  hear  in  mind  the  fact  that  tlie  greatest  circum- 
ference of  the  tooth  is  at  the  gingival  plane  of  the  occlusal 
third,  and  then  foi-m  a  right-anglcMl  ti-iangle,  the  luise  of  which 
is  formed  hy  a  line  dro])))*'*!  fi'oin  the  liighest  occlusal  eminence 
to  a  point  of  intersection  with  tlic  line  rising  from  the  gingival 


EXTENSIVE    ItKSTOKATlOXS    OK    OCCl.rSAI.    nALAXC'E 


255 


t'irt'uiiircrciicc,  to  llic  ^iii^ival  ])laii('  of  llic  occlusal  third,  tlie 
latter  is  the  line  of  altitude  of  the  i'i,i;ht-aiiKl<"d  triaiift'le,  while 
its  hypotlieiiuse  is  roniicd  1)>-  the  direct  line  dropped  from  the 
occlusal  eminence  to  the  <;in.i;ival  circund'ei-ence  as  illustrated 
(1-8,  Fig.  203)  on  the  chart. 

This  holds  good  for  the  contouring  of  the  four  surfaces  of 
the  tooth,  in  the  case  of  these  restorations,  the  surfaces  heiug 
pi-actically  intact  with  the  exception  of  ])ortions  of  proximal 
areas.     The  following  geometric  di-awing  will  aid  in  determin- 


UrtctKrou^K  cunXfc  of  pup 
Orbito-Uasal  Una,  1 7s  vucKeS,- -' 


y^^---  /B  iucKeS  lower  Up 


Uppev  Up  ^4it\cKt5 -V-V--< 


TlaSo-HUnial  lme2)iiivcluk 

2  tuike^',  ! 


Fig.  202. 

ing  definitely  the  extent  of  the  mesio-distal  restoration  re- 
quired to  obtain  a  normal  contact  area  between  the  teeth  mesio- 
distally. 

The  figures  enclosed  by  the  letters  BCEF  and  KHOP 
(Fig.  203)  show  two  central  cubes  of  two  adjoining  teeth,  as 
they  would  rise  minus  any  contour  from  the  gingival  j^lane  of 
the  gingival  tlnrd  of  the  tooth.  In  adding  the  proper  contour 
mesio-distally,  the  mesio-proximal  triangle  ELF  of  the  pos- 
terior tooth,  dips  or  extends  into  the  disto-proximal  triangle 


256 


CAST    GOLD    AXP    rORCEI.AlX    IXLAYS 


bo 


I'A'i'i-: xsixi'.   i;i;s'i'(»i:.\'i'io\s  oi'   occi.rsAi,   i!.\i,.\.\('i':  'J.)( 


It  must  ]h'  Inline  ill  miiul  that  tliis  fliart  rcprcsfiit.s  a  tootli 
gooiiietric-ally.  It  is,  tliorofoio,  coiivfMitioiializpd.  A  variation 
prosonts  itself   in    the   location   of  the   linlit   anj^los,  as  follows: 

In  Ujipoi-  niolais  the  rii;lit  anisic  jircscnts  at  tlio  giiij;ival  piano 
of  the  occlusal  tliinl  luiccallv,  and  the  j4inoi\al  plane  of  the  midille 
third  palatal ly. 

In  lower  molars  the  ri^ht  anj;le  presents  at  the  oinoixal  |>l;ine 
of  the  middle  third  huccallv,  and  at  the  ninqival  plane  of  the 
occlusal   thiid    linjiually. 

Furthermore,  if  we  lay  out  the  respective  right  an^lrs  of  the 
upper  and  lower  molars  and  continue  the  bases  and  altitudes  until 
they  intersect,  we  will  produce  squares  with  sufficient  variations 
in  their  lines  of  direction  to  account  for,  and  to  coincide  with,  the 
rhomhoidal  and  trapezoidal  figiire.5  of  the  gin^ival  jdanes  of  the 
gingival  thirds  of  the  respective  teeth. 

Fig.  1. — ^lolar  crown  divided  horizontally  into  thirds. 
J  A.  Occlusal  third. 
BB.  Middle  third. 
CC.  Gingival   third. 

Fig.  2. — Same,  with  thirds  separated. 

AJ.  Gingival  plane  of  occlusal  third. 
BB.  Occlusal  plane  of  middle  third. 
CC.  Gingival  plane  of  middle  thiid. 
BD.  Occlusal   plane   of   gingival   third. 
£7?.  Gingival  plane  of  gingival  third. 

Fig.  .'!. — Gcometiic  construction  of  contours  of  molars.  A 
line  drawn  from  highest  eminence  of  cusp,  to  a  point  on  the 
circumference  of  the  tooth  at  its  neck  (XY) ,  becomes  the  Iiypothe- 
iiuse  of  a  right-angled  triangle  (XYZ),  the  right  angle  of  which 
will  lie  opposite  the  gingival  plane  of  the  occlusal  third.  XTZ. 
the  right-angled  triangle.  XY,  the  hypothenuse.  XZ,  base  of 
triangle.     XY,  altitude  of  triangle. 

Fig.  4. — Geometric  solid  figure,  properly  triangulated,  from 
which  molar  crown  may  be  carved. 

Fig.  5. — Same  Avith  component  sections  separated.  A.  Cen- 
tral rectangidar  pillar.  B.  Mesial  wedge-shap)ed  section.  C.  Lin- 
gual wedge.  D.  Distal  wedge.  E.  Buccal  wedge.  F.  Mesio-buccal 
angle  section.  Triangular  pyramid  inverted.  G.  Mesio-lingual 
pyramid.     H.  Distodingual  pyramid.     /.  Distodniccal  pyramid. 

Fig.  6. — Geometric  figure,  showing  second  stage  of  carving 
molar  crown,  the  cusps  appearing  as  quadrangular  pyramids. 

Fig.   7. — Third   .stage.     One  half  of  crown   carved   out. 

Fig.  8. — Crown  completed. 


258 


CAST    GOLD    AXD    POrtCELAIN    INLAYS 


KM II  oi'  the  anterior  tootJi,  in  siicli  a  manner  tliat  a  quadri- 
lateral iigure  IMJL  is  formed. 

If  a  perpendicular  line  TIG  is  drojiped  between  the  two 
teeth,  it  will  bisect  this  quadrihiteral  figure,  and  will  also  be 
tangent  to  the  two  arcs  UV  and  ST  both  arcs  being  parts  of 
two  circles  the  centers  of  which  lie  externally  to  the  two  teeth 
involved. 

In  the  former  chart  of  geometric  tooth  construction  within 
the  two  triangles  XYZ  is  seen  a  dotted  line  indicatmg  the 
api)roximal  contour  of  a  molar  tooth,  and  by  stud^dng  the  two 
charts,  the  student  will  know  how  to  determine  the  extent  to 


Fig.  204.— The  figures  cudoserl  hj  the  letters  BCEF  and  KNOF  show  two  cen- 
tral tubes  of  two  adjoining  teeth  as  they  should  appear  when  dressed  down  to  receive 
crowns.  The  mesio-proxinial  triangle  ELF  of  the  posterior  tooth,  dips,  or  extends 
into  tlie  disto-proximal  triangle  KMN  of  the  anterior  teeth  in  such  a  manner  that  a 
quadrilateral  figure  IMJL  is  formed.  If  a  perpendicular  line  EG  is  dropped  betwo::'n 
the  two  crowns,  it  will  bisect  this  quadrilateral  figure  and  will  also  be  tangent  to 
the  two  arcs  VV  and  ST,  both  arcs  being  parts  of  two  circles,  the  centers  of  which 
lie  externally  to  the  two  teeth  involved. 


which  his  ajJijroximal   eoiitoui-  line  should  lie  within   tiiat  tri- 
angle at  the  point  of  a])proximal  contact. 

AVhen  with  a  view  to  all  factors  involved  (diagrams  of 
stress  and  contour),  immunity  and  re-creation  of  balance,  the 
cavities  in  the  first  molars  and  second  bicusj^ids  have  been  pre- 
pared, and  the  inlays  completed  and  cemented  into  place,  all 
of  which  was  done  while  the  partial  s])lint  remainecl  in  jjosiiion 


EXTENSIVE    llESTOltATIOXS    OT    OCCLrSAI.    UAI^AXCE 


259 


Fig.  205. 

Fig.  1  is  a  horizontal  section  representing  the  occlusal  plane  of  the  middle 
third  of  an  uj)per  second  bicuspid.  The  heavy  curA-ed  lines  within  the  circle  repre- 
sent the  mesial  and  distal  surfaces,  while  the  dotted  curved  lines  indicate  the  form  and 
proportionate  height  of  the  buccal  and  lingual  cusps.  ABC  is  an  isosceles  triangle 
which  has  the  line  JB  as  the  base,  and  the  lines  AC  and  CB  the  respective  sides. 
The  angle  ACB  is  tlie  apical  angle,  and  being  bisected  by  the  line  CD,  this  same  line 
will  also  bisect  the  lingual  cusp  of  tlie  upper  second  bicuspid. 


Fig.  2  is  a  horizontal  secition  representing  the  occlusal  plane  of  the  middle  third 
of  a  lower  second  bicuspid.  The  heavy  curved  lines  within  the  circle  represent  the 
mesial  and  distal  surfaces,  while  the  dotted  curved  lines  represent  approximately 
tlie  buccal  and  two  lingual  cusps.  EGF  is  an  isosceles  triangle,  with  the  line  EF  as 
the  base,  and  the  lines  EG  and  FG  as  the  respective  sides.  The  angle  EGF  is  the 
apical  angle,  and  being  bisected  by  the  line  GH,  the  same  line  will  also  bisect  the 
buccal  cusp  of  the  lower  second  bicuspid. 


2(i0 


CAST    COIJ)    AND     I'()|;ci;LA1  X     l.\l,A\'S 


on  the  ()])j)()sit('  side  of  the  iiioiitli,  sup|)l  \  iiii;'  tlic  cU'liiiitt'  ]iLMi!,lit 
to  ^v]li('ll  tlu'  Iceth  heiiiii,'  restored  were  to  ho  raised,  that  part 
of  the  rul)))er  spliid  Jittiiig  over  and  around  the  ]-estored  area 
is  eased  so  that  it  Jiia\-  i:,o  to  place  and  rest  npon  the  teetli  not 
yet  rehuilt. 

All  additional  section  ol'  the  pai'tial  s])lint,  l)elon<i,iiifi'  to 
the  side  in  tlie  ])ro('ess  of  restoration,  is  now  removed  with  a 
fine  saw;  enon^ih  is  cut  out  so  that  the  second  molars,  npper 
and  lower,  may  he  worked  upon.  AVhen  these  are  finished,  the 
rnhher  s]tlint  is  eased  ii])  at  tliese  areas,  and  the  jiartial  s])lint 


Fig-.  206. — Rliowiii:;  Imw  jK-ifoetly  Ofclusul  surfaces  may  1)C  carved  in  tlie  wax 
and  roiiroflueod  liy  nicjiiis  of  tlie  casting-  pioccss.  JIcvc  tiic  left  upper  fust  molar 
lias  l)Pon  exactly  copied  and   i-ej]roducei]   in  gold.      (Dr.  .1.   Ijonvc  Young.) 


['<)]•  that  side  may  ))e  ])ut  a\va_\'  as  part  of  the  recoi'd  of  tlie  case, 
and  tlie  first  ])iciispid  cavities  inav  he  prepai'e(l  and  inhiyech 
The  i-nhhei'  Splint  is  ailju>1ei|  to  niak'e  it  conronn  to  the  new 
conditions  hy  i'enio\iii,i;-  ,-ill  ol'  llie  orclnsnl  snrl'ace  of  il   on  that 

h  Is  then  plac«(|  in  1  he  oral  ca\  Il>'  and  1  he  space  pi'e\Ionsly 
occnj)ied  hy  the  ent  end  section  is  lill(M|  willi  a  roll  of  ncIIow 
wax,  the  palicnt  is  direelfd  1o  close  llie  nionlli  nnlil  the  teeth 
()]\   the  other   >ide   are    in    oeehisal    I'elalion    willi    the   s|)linl.      .V 


EXTKN'SIVK    r.KS'roilATloXS    OF    OCCIJSAl.    I'.ALAXCE 


'_>(;i 


few  mimitcs  arc  allowc*!  for  the  wax  to  harden,  'riic  <\)\'\\\i  JS 
removed,  (lasked,  cleaned,  packed,  vulcanized,  and  ])()lislied.  It 
is  I'etunii  d  to  llie  palieid  at  the  next  sittin;^-,  wlien  the  ])r()ce(lure 
'»r  I'csloralion  i>  a-ain  slailed  witli  tlie  lii^t  mohirs  and  second 
bicuspids  of  the  opposite  side. 

At  this  point  we  iiia\-  dispense  alto;j,<'tliei-  witli  the  i-einain- 
iuf;-  ])artial  s|)lint,  the  opposite  side  ^ivin,:;-  a  icliahle  occlusal 
<;uide. 

'I'hus  we  -o  to  the  second  niolai's  and  thifd,  if  any  he  pi'es- 
eiit,  and  linally  to  the  first  l)icus])ids,  easing  the  iiihber  splint 
froin  time  to  time  until  tlie  first  bicuspids  have  been  ruily  re- 
stored, when  the  lubber  s])lint  may  also  be  dispensed  with.  We 
shall  lind  now  that  the  naso-mental  line  has  increased  in  length, 
that  the  jjosterior  teeth  are  in  normal  mesio-ilistal  relation,  and 
that  we  have  re-created  an  occlusal  balance  of  the  ])osterior  ])art 
of  the  masticatinft-  apparatus  which  will  leave  nothing-  to  be  de- 
sired, and  the  perfection  of  which  we  never  could  have  e\-en  a])- 
])roached  without  the  help  of  the  casting-  process. 

The  followin-;'  is  a  quotation  from  an  editorial  written  for 
the  JJcntdl  Items  of  Iittrrrst,  .May,  1913,  by  Dr.  Ottoleni-ui,  an 
editorial  which  has  the  distinction  of  bein<;'  timely  and  true. 

"In  the  past  we  have  contoured  teeth,  but  we  have  not  con- 
toured them  to  the  extent  implied  by  the  word  'restore.' 

"The  contourists  have  replaced  corners,  have  built  u])  in- 
cisal  M^^i^><  with  fair  accuracy,  and  tliey  have  even  rounded 
out  the  approximal  or  circumferential  sha])es  of  teeth.  But 
tlicy  have  irorfiiJIii  failed  to  even  fairly  ivdl  imitate  the  oeclusal 
surfaces  of  bieuspids  and  molars. 

"Perhaps  never  until  now  has  the  dental  world  been  fully 
aroused  as  to  the  iin])()rtance  of  restoring  occlusion.  The  or- 
thodontist and  the  prosthodontist  have  far  outstri])ped  the  den- 
ists  in  this  ]-es])ect,  but  the  time  has  now  arrived  when  tiie  ilen- 
tist  must  awaken  and  grasp  the  need  of  making  occlusion  the 
fundamental  princii)le  of  everyday  work. 

"Any  child  would  tell  us  'teeth  are  made  to  eat  witli.'  The 
great  Master  so  formed  these  oigans  tliat  they  would  not  only 
'eat,'  but  'eat'  well.  The  slightest  loss  of  any  ])art  of  the 
masticating  surface  of  a  tooth,  the  most  minute  change  in  its 
designed   roiiii,  diminishes  its  usefulness  as  a   masticatory  or- 


262 


CAST    GOLD    AXD    PDIlL'ELAlX    i:s'LAYS 


.Fig.  207. 


Fig.   208. 


EXTENSIVE    ItESTOKATlUXS    OF    OCCLL'SAL    IJALAXCE 


203 


Fiff.    209. 


Fig-s.  207,  208,  and  209.— Three  illustrations  of  lieautit'ul  oc- 
clusal surfaces.  Two  lower  models  above,  and  one  upper  model 
lielow.  Xote  carefully  the  second  lower  bicuspids  and  second 
upper  bicuspid.  Note  also  the  continuity  of  the  disto-buccal  cusp 
of  the  first  upper  molar  with  the  mesio-lingual  cusp.  (Dr.  J. 
Lowe  Youiic'.) 


204 


CAST    GOLD    AND    POllCELAIX    INLAYS 


g'an  to  just  tliat  extent,  lieversely,  wlicre  ])art  or  all  of  the 
occlusal  surface  of  a  tooth  is  lost  tlir()U,i;h  caries,  the  more 
nearly  tlie  dentist  succeeds  in  restoiiii.i;'  its  original  form,  the 
more  perfect  does  he  make  the  ])atieut's  al)ility  to  masticate 
food. 

"Hundreds  of  articles  have  l)een  wi-itteu  u])on  the  need  of 
restoring   ai)proximal   contact   as   a   ])rotection   to   the   gingiva 


Fig.  210. — Xote  the  two  illu.stratioiis  on  the  lower  portion  to  the  left,  with  their 
inefficient  occlusal  surfaces,  and  compare  the  four  other  illustrations  with  their 
definite  .sulci,  cusps,  and  fissures. 


which  iiOi-iiiall>'  fills  the  iii1<'r])roxiiiial  space;  hut  a  close  study 
of  the  anatomy  of  tlie  i"(-gioii  will  deiiioiislrale  that  the  con- 
tact of  adjacent  teelli  is  only  one  ol'  .Vatiiic's  measures  foi'  the 
jii'otection  of  tlie  gingiva,  and  not  the  most  important.  At  the 
approximal  margin  of  tlie  occlusal  siiifatM'  of  molar  or  hi- 
cus])i<l  N\ill  Ik'  round  a  marginal  ridge  witli  i1>  most  slanting 
plane  extending  ar()iiiid   the  center  of  that    sniTaee,  and  there- 


FA'TEXSIVE    r.ESTOUATIOXS    OF    OCCIA'SAL    BALAXCK 


I'd.-) 


Fig.  211. — Tins  illiistratidii  anil  Fi-.  I'll'  arc  sliowii  to  call  to  Tuiiid  tlio  M'ays 
in  Avliich  attrition  manifests  itself  in  (liff"(Mviit  tvprs. 

Note  in  this  ilhistration  a  groat  amount  of  attrition,  and  vet  very  well-dofinod 
and  rather  deep  ocidu.sal  ploncs.  Note,  also,  to  tlic  rif>lit  a  iiial}n)sitiou  of  the  bicus- 
pids and  a  consequent  narrowing  of  the  arch.  This  may  be  called  a  thyro-adrenal 
tooth.  It  is  the  tootli  of  tlie  dreamei',  the  poet,  and  highly  artistic  architect,  the 
landscape  gardener,  tlie  artist,  more  so  tlie  impressionist,  jiooplc  of  culture,  and  us- 
nally  ]ieople  of  great   sincerity. 


Fig.  212. — Another  type  of  the  result  of  attrition.  The  cusps  and  i^lanes  are 
not  so  deep,  not  so  well  defined  and  the  arch  is  wider.  It  is  the  pituito-guuado- 
adrenal  type.  It  belongs  to  the  imlividual  who  lives  in  conformity  to  form, — works 
<>ight  hours,  sleeps  eight  hours,  and  plays  eight  hours,  etc.  He  makes  no  laws, 
they  are  made  for  liim.  He  docs  not  dream  or  speculate,  dees  not  philosophize.  He 
votes  with  the  mass.     lie  is  not  the  creative  type. 


2GG 


CAST    GULL)    AXD    POllCELAl^;    JXLAYS 


Fia-.  213. 


:i4. 


riff.  215. 


A  Case  of  Extensive  Eestoration. 

Fi{^.  213. — Tlic  models  of  tlic  case  after  inlays  wore  inserted.  As  Jiiay  Le  seen, 
tlii.s  case  presents  consideralde  nial])0.>ition  of  a  number  of  teeth.  Note  the  occlusal 
surfaces,  the  distinct  cusjts,  sulci,  niai^^iiial  ridges,  and  the  essential  hell  shape  of 
tlie  teeth  as  a  whole. 

Fig.  214. — Anterior  view  of  models  in  (icrdusion.  Note  the  (ivciliite,  the  ten- 
dency to  tortion  of  the  right  lateral. 

Fi":.  21.J. — A  side  view  of  he  sanu;  mcMleis   in   orclnsidii. 


EXTENSIVE    ItESTOr.ATlOXS    OF    OCCLVSAl.    IJALAXCE 


267 


Fi-.  216. 


Fig.  217. 


Fig.  218. 


A  Case  of  Extensive  Kestoratiox — Coxt'd. 

Fig.  216. — A  lingiial  viow  of  the  niodcl.s  in  oecliisiuii.     Note  the  correct  inter- 
digitation  of  the  cusjis. 

Figs.  217  aud  218. — Views  of  the  same  models  in  occlusion^  but  cut  in  half  to 
show  tiie  inlays  more  clearly  in  outline  and  occlusion. 


'2GS  CAST    GOLD    AXD    rORCELAlX    JXLAYS 

fore  away  from  the  ai)i)roxinial  sijace.  Tliese  marghial  ridges 
lead  down  into  gntters,  wliicli  in  turn  carry  the  escaping  food 
lingually  and  l)nccally.  so  tliat  in  the  normal  state  the  contact 
l)oints  need  1)e  hnl  small  rounded  areas,  as  tliey  are,  to  prevent 
food  from  crowding  (k)wn  against  the  sensitive  and  easily  in- 
jured gingiva.  Thus  the  absolute  copying  of  Nature  in  the 
restoration  of  occlusal  surfaces  of  molars  and  hicusjoids  not 
only  increases  the  masticatory  efficiency  by  supplying  cusj)s  and 
fossa\  hut  protects  the  soft  parts  and  j^reserves  them  in  a  state 
of  health  because  of  the  marginal  ridges  and  sulci." 

SUMMARY  FOR  CHAPTER  XVIII 
Extensive  Restorations  of  Occlusal  Balance  by  Means  of  Gold  Inlays 

1.  Xanio  the  two  causes  of  the  mutilation  of  tlic  occlusal  and  proximal 
surfaces. 

2.  A\'liat  are  tlie  ijielimiuaiy  steps  beftjre  Ijeyinniug  a  ease  of  extensive 
restoration? 

3.  Explain  tlie  method  of  making  a  diagram  of  stress  from  the  model. 

4.  Explain   the  reasons   for  the  choice   of  the  first  tooth  to  be  ojierated  ui)Oii. 

5.  "What  are  the  causes  of  attrition?  Name  a  predisposing  cause.  Name 
a  secondary  cause. 

f).  Describe  the  oral  conditions  in  a  case  of  marked  attrition. 

7.  How  would  you  determine  the  amount  of  gingivo-occlusal  restoration 
to  be  made? 

8.  "What  steps  should  first  be  taken  in  the  actual  process  of  Avork  upon  the 
patient? 

Construction  of  the  Splint 

1.  Describe  the  making  of  the  spliiit,  giving  the  various  steps  on  the  model 
and  in  the  mouth. 

2.  How  would  you  determine  the  am.ount  of  opening  of  the  articuuitur  tlic 
case  requires? 

3.  What  is  the  reason  for  doubling  the  amount  of  the  necessary  gingivo- 
occlusal  restoration? 

4.  What  is  the  naso-mental  line  and  liow  is  it  taken  into  consideration 
while  making  the  restoration? 

i).  Describe  the  construction   of  :i    initial   splint. 

G.  With  the  teeth  in  ncjrmal  mesio-ilisf  al  j-ehition,  how  is  llic  aiiKtiiiit  of 
building  up  dcterniincfl? 

7.  Descrilie  tiic  ciiangcs  in  tlic  I'lill  sjilint  wliilc  tlic  lunccss  of  iccoiist  iiictiou 
proceeds. 


(MIAPTKIJ  XIX 

<;()ij)  lXLA^'s  AND  rwi:  siucA^rKS  on  i^ouckj.aix 

For  eosiiictic  fcasoiis,  too  well  l<iio\vii  to  require  any  lenf>'tliy 
eoiKsiclerntion,  the  cast  o-old  inlay  is  in  itself  C'ontraindieate(l 
ill  anterior  teeth  and  even  tirst  l)ieusj)ids,  in  sncli  ])ositions  as 
will  ex|)ose  aii_\'  eoiisiderable  i)()i'tioii  ol'  tlie  ,i;old  to  tlie  vision 
of  the  person  with  whom  tlie  patient  eoiiies  in  eontaet. 

Yet  in  a  <;reat  many  eases  of  broken  or  worn  down  an- 
terior teetli,  the  east  ft'old  inlay  is,  from  all  ])oints  of  view  hut 
the  one  mentioiie(l,  the  very  l)est  restoration  possible;  in  faet, 
it  it  were  not  for  this  cosmetic  ol)jection,  the  east  ft'old  inhiy 
would  i^rove  the  ideal  restoration  for  large  areas  in  anterior 
teeth,  and  it  must  I'ohow  that  if  this  one  objection  can  be  over- 
come, we  shall,  in  the  cast  gold  inlay  have  as  j^erfect  a  re- 
creative process  for  anterior  teeth  as  it  has  proved  itself  to 
l)e  for  posterior  teeth. 

This  conclusion  led  me  to  a  series  of  tests  and  experiments 
which  were  not  restricted  to  my  own  j^ractice  at  all,  but  were 
no  doubt  carried  on  by  a  great  minil)er  of  men  who  realized  the 
advantage  of  the  casting  process  and  were  desirons  of  over- 
coming the  obstacles  to  its  use  in  the  anterior  teeth. 

Excejjt  to  a  vei-y  limited  extent,  I  have  no  means  of  de- 
termining just  hoAv  extensive  these  experiments  of  the  other 
men  have  been,  or  how  successful  they  have  proved,  but  I  am 
in  a  position  to  state  that  in  my  own  jn'actice,  the  cosmetic  ob- 
jection to  the  cast  gold  inlay  in  anterior  teeth  has  been  entirely 
overcome  by  the  use  of  porcelain,  or  the  silicates  in  conjunction 
with  the  inlay. 

Broadly  speaking,  all  but  the  part  exj^osed  to  view  is  re- 
l)laced  with  a  gold  inlay,  and  a  portion  of  the  gold  inlay  is  so 
sha])ed  that,  with  the  remaining  part  of  the  tooth,  it  will  offer 
the  means  of  the  construction  of  a  simple  cavity,  which  may  be 
inla^'^ed  with  porcelain  or  filled  with  a  good  silicate  cement. 

In  cases  of  marked  attrition,  where  the  crowns  of  anterior 

209 


270 


CAST    GOLD    AXD    TORCELAIX    INLAYS 


Fijr.  219. 


Fio-.  220. 


Q 


Fi-    22L 


Fi-    21 


Fiff.  222. 


Fig.   224. 


Fitr.  22.J. 


GOLD    INLAYS    AXD    THE    SILICATES    OK    POIICELAIX  liTl 


Gold  Inlays  and  Porcelain  or  the  Rilicates. 

A  Number  of  Views  of  a  Lower  Central  Fk  vctured  in  a 
Fall. 

Fig-.  219. — Liiioual  view  of  cavitv. 

Fig.  220. — La])ial  view  of  cavity. 

Fig.  221. — Wax  inlay  before  providing  room  for  porcelain. 

Fig.   222. — Wax  inlay  in  jiosition   carved   out   to   make   pro- 
vision for  porcelain  or  silicate. 

Fig.   223. — Wax   inlay  ready   to   be   mounted   on   sprue   wire 
for  investment  in  refractory  compound. 

Fig.  224. — Labial  view  of  completed  operation. 

Fig.  22.5. — Lingual  view  of  completed  operation. 

Stress   Index:      Downward,   inward    and    forward,    or   Intra- 
alveolar    linguomesiaUy.      . 


I'ASr    COLli    AND     l'()Ii('l-:LAI  X     I  X  I  .A  \ 


Fiir.  :2U(i. 


Fio-.   227. 


□ 


Fi-.    22S. 


Fill.    22!). 


Ki"'.  2:!!). 


i'l-.  2:;  I. 


l-'\'^.  2:;2. 


COLD     l.\•|,.\^S    AMI    'I'lll':    SIIJCATKS    Oi;     I'OlM'Ki.AlX 


A  Xtmber  of  Views  of  a  Lower  Lateral  Restored  i;y 
^[kaxs  of  a  Cast  Gold  Ixi.av  axd  Ryxthetic  Porcelain'. 

Fi-)'.  '2'2i). — Lnliio-distal  \i('w  of  |no])ai('(l  tootli.  Xoto  l)Ovo]s 
at  incisal,  distal,  and  gingival  margins. 

Fig.  1*27. — Ling'uo-iiieiso-distal  view  of  proparea  tootli.  Xotc 
appearance  of  cavo-surface  and  the  t-oiitinuity  of  linguo-niesial 
and  linguo-gingival   bevel. 

Figs.  228  and  220. — Lingual  and  cavo-surface  view  of  wax 
iiday. 

Fig".  230. — AVa.x  iiday  in  position  on  tlie  tooth,  jnovision  made 
for  porcelain  or  synthetic  inlay. 

Figs.  231  and  232. — Lingno-inciso-distal  and  labio-distul 
views  of  the  finished  operation. 

Stress  Index:  Downward,  inward  and  forward,  or  TxTKA- 
ALVKor.Aij    lUiriun-Dx  fiUilhi. 


274 


CAST    GOLD    AXn    roiU'KLAlX    IXLAYS 


Fio-.  233. 


Ficr.  234. 


Fiff.  235. 


Fis.  236. 


Fii 


Fi-.  238. 


Fi-.   23!t. 


COLT)    IXLAYS    AND    THE    SILICATES    OR    TORCHLAIX  _(•) 


A  Number  of  Views  of  a  Lower  Lateral  Involved  by 
Fracture  and  Decay  Bestored  by  the  Use  of  a  Gold  Ixlay  ix 

COXJUXCTIOX    WITH    SILICATE    CeMEXT, EOOT    FILLED. 

Fig-.  2.''>.3. — Laliial  view  of  ■ineparoil  c-avity. 

Fig.   234. — Lingual  view  of  i3iepare<l   r-avity. 

Fig.  235. — Wax  inlay,  lingual  view. 

Fig.  236. — Wax  inlay  in  position  on  the  tooth,  wax  carved 
out  to  provide  room  for  porcelain. 

Fig.  237. — Wax   inlay  ready   for   sprue  wire  for  investment. 

Fig.  238.^Labial  view  of  finished  operation. 

Fig.   239. — Linguo-mesial  view  of  finished  operation. 

This  proved  a  useful  and  lasting  operation  of  fine  appear- 
ance. 

Stress  Index :  Downward,  inward,  forward,  or  Ixtraalveo- 
i.ar  Jinfnio-nxsiuJh/. 


L(()  (."AS'r    COLD    AND    I'OKCKl.A  I  X     IXl^AVS 

teeth  liave  l)eeii  reduced  to  oiu'-lliird,  or  even  oiie-lialf  tlieij' 
leno'tli,  tliis  iiianner  of  restoration  lias  l)een  so  Yalna1)1e  that  it 
may  he  insisted  on  as  tlie  only  logical  one. 

Where  the  peridental  tissues,  and  l)y  litis  are  meant  all 
the  tissues  in  the  region  of  the  lieridcnial  iiiciiihrane,  such  as  the 
gingiva,  the  alveolus,  the  suspension  ligament,  and  the  gingival 
and  suhgingival  circumference  of  the  tooth,  are  free  from  any 
patliologic  invasion,  and  where  the  remaining  portion  of  the 
tooth  crown  is  free  from  caries,  the  excision  of  that  portion 
and  the  suhstitution  therefor  of  an  artificial  snhstance  is  a  need- 
less sacritice  of  structure  and  may  he  avoided  hy  resorting  to 
the  cast  gold  inlay  in  coml)ination  with  the  silicates  or  j)or- 
celaiu. 

In  this  way  also  any  possihility  of  injuring  the  tissues  in 
the  i^eridental  region  is  avoided,  and  the  greater  longevity  of 
the  restored  tooth  assured. 

This  is  hy  no  means  to  he  considered  as  an  argmnent 
against  i:)orcelain  crowns  in  general,  or  as  a  condemnation  of 
the  jDorcelain  inlay  in  general;  each  has  its  place,  and  in  its 
place  it  can  not  he  successfully  supplanted  hy  any  other  res- 
toration, hut  there  can  he  no  question  ahout  its  having  been 
employed  in  cases  Avhere  the  cast  gold  inlay,  in  combination 
with  one  of  the  silicates  or  joorcelain  could  have  been  used  to 
nuich  greater  advantage. 

It  will  be  well  to  note  that  in  all  large  restorations  of  the 
anterior  teeth,  the  extirpation  of  the  pulp  is  usually  warranted, 
and  most  often  imperatively  indicated,  and  the  reason  for  this 
is  found  ill  tlic  ])articular  formation  of  tlio  anterior  crowns. 
AVhen  a  large  portion  of  these  crowns  has  been  lost  through 
caries  or  attrition,  we  are  compelled  by  the  laws  of  i)hysics 
to  invade  that  ])ai't  of  the  remaining  ci'own  which  is  greatest 
in  biillv'  and  most  likely  to  resist  stress,  and  thus  offers  a  better 
seat  for  our  restoration  with  a  view  to  conservation  of  llie 
tooth  as  a  whole,  and  we  shall  find  that  this  ])a]'t  of  the  remain- 
ing crown  is  usually  occupied  by  the  pul]),  so  lliat  ])roper  root 
canal  woi-k-  becomes  an  iiii])orlaiit  factoi',  and  is  the  first  sur- 
gical operation  to  be  considered  in  these  cases. 

The  root  canals  ai"e  filled  from  the  a])ex  down  to  one-third 
of  the  length  of  the  canal,  the  reinaining  poiiioii  of  the  canal 


(iOl.l)    JNJ.AVS    AXI)    THE    SILKJATKS    OK    l'(  »i;( 'KLA I  X  -i( 

roamed    out   to    receive    a    1")    to    iM)    pci-    cent    iri(lio-])latiiiiiiii 
tlireaded  post,  wliidi  post  hccoiiics  a  pail  of  the  cast  ft'old  ialay. 
Tlie  sizes  of  tlu'  posts  foi-  liic  Narious  teeth  iiia>'  he  staii<l- 
ardi'/ed  as  I'olhjws: 

Upper  cent r;i I  incisors  and  cnspi'ls 1 1^  ^:>ii.^<'    (l''«!i:!S 

Upper  lateral  incisors    11      " 

Bicuspids  single  root    1-i      " 

Lo^Yer  central  and  latcrnl  incisors   Ki      " 

Low^T  cuspids    1  •'>      " 

Lower   bicuspids    1-i      " 

All  these  ])osts  may  he  kept  on  hand  under  sejKirate  eovei'S 
in  two-iueh  h'ii,i;-tlis.  The  re('ei)taele  may  he  marked  on  the  out- 
side so  as  to  indicate  the  contents. 

The  following  simple  rules  mnst  l)e  rememl)ered  in  con- 
nection with  the  nse  of  posts: 

1.  The  ijost  is  to  aid  in  making  the  artificial  restoration 
and  the  remaining  portion  of  the  tooth  heing  restored,  one  con- 
tinnous  memljer,  the  cement  being  the  intermediary  agent. 

2.  The  longer  and  stouter  the  post  (within  the  limit)  the 
greater  the  area  of  contact  surface  and  the  greater  the  resist- 
ance to  stress. 

o.  The  length  of  the  post  should  he  at  least  %  the  length  of 
the  root.  Additional  contact  s\irface  is  ol)tained  hy  threading 
the  post. 

In  accordance  witli  all  the  laws  of  cavity  preparation,  and 
in  accordance  with  the  diagram  of  stress,  the  cavities  are  then 
prepared  and  the  wax  inlays  are  made,  which  wax  inlays  mnst 
engage  the  post.    This  is  accomplished  in  the  following  manner: 

A  cone  of  inlay  wax  softened  as  i)reviously  directed,  is 
forced  into  the  cavity  and  chilled  uiidei-  pressure;  with  the 
])roper  carvers  the  wax  is  then  trimmed  to  size  and  contoui', 
the  right,  left,  and  straight  ])nrnishers  assisting  in  the  opera- 
tion. A  hole  is  then  made  in  the  contoured  wax  inlay  lingnally, 
this  hole  going  right  through  the  wax  and  leading  into  the 
root  canal.  The  hole  slionld  he  somewhat  smaller  in  size  than 
the  threaded  ])ost.  The  latter  is  grasped  in  a  pair  of  iDliers, 
slightly  heated  in  tiie  Ihuiie  ol'  the  alcohol  lamp  or  Bunseii 
hnrner,  and  I'orced  into  the  hole  in  the  wax  iiday,  and  put  into 


278 


CAST    GOLD    AXD    POKCELAIX    INLAYS 


Fio-.  240. 


Fi?.  241. 


Fijr.  242. 


Fio-.    243. 


Fiff.   244. 


Fi-'.  245 


Fiii.  24G. 


OOLI)    IXLAYS    AXn    TIIE    SILICATES    OR    TORCELAIX  27'J 


A  Numbi':r  of  Views  of  a  Lower  Lateral  Fractured  ix  a 
Fall.     Extirpated  Pulp. 

Fig.  240. — Laliial  view  of  cavity.     Xote  lievel  and  step. 

Fig.  24L — Liiigiial  view  of  cavity.  Note  "jovel  and  lingual 
lock  step  with   depression  into  pulp  canal. 

Fig.  242. — View  of  wax  inlay  before  providing  room  for  por- 
celain. 

Fig.    24.3. — Wax   inlay   carved    out   to    provide    for    jiorcelain. 

Fig.  244. — AVax  inlay  ready  to  be  mounted  upon  sprue  wire 
for  investment. 

Fig.  24.3. — Mesio-lal)ial  view  of  finished  operation. 

Fig.  246. — Mesio-lingual  view  of  finished  operation. 

Stress  Index:  Downward,  inward  and  forward,  or  Intra- 
alveolar   Unguo-mcsially. 


280 


CAST    GOLD    .VXD    rORCKT^AlX    IXLAYS 


Fiff.  24; 


Fio-.  248. 


Fitr.    249. 


Fijr.    250. 


Fiff.  2.:i. 


Fi-.  2:> 


Fiy.  25:i. 


COLD    INLAYS    AND    TllH    SILK'ATKS    Ol!    I'OIICLLAIX  281 


8EVEX     VlKWS     OF    A     LOWER     CL'SPID,     PrESEXTIXG     ANOTHER 

Type  op  Eestoratiox.  also  a   Combixatiox   Cast  Gold  Ixlay 
AXD  Porcelain  Ixsert. 

Stress   Index:      Downward,    inward,    forward,    liack    and    out- 
ward or  IxTRAALVEOLAR  linguo-mcsiolJ ij   and   disto-UihinUij. 


282 


CAST    GOLD    A>:i)    roltCEF.AlX    INLAYS 


□ 


Fio-.  254. 


Fig.  255. 


Fig.  25f). 


Fig.   257. 


Fig.   255 


Fig.  2.59. 


Fig.  200. 


IIOI.I)    l.XLAVS    A.\l»    TliE    SILICATES    (M!    i'OlH'KI.AlX 


Seven  Views  of  a  P.koke.\-down  Cuspid  Ekstoked  with  a 
Cast  Gold  Inlay  axd  a  Pokcelaix  Insert.  The  Illustrations 
ARE  Self-explanatory. 

Stress  Index:  DdWinvaiil,  inward,  forward,  liafk  and  out- 
ward or  Intkaalyeolak  liiiritiu-ntr.sialli/  and  (listo-hihialli/. 


284 


CAST    COLD    AXD    POKCELAIX    INLAYS 


Fig-.  2(31. 


Fio-.   262. 


Fitr.  26:5. 


Fio-.   264. 


Fig.  265. 


Fig.   2(iii. 


Fi-    2<i7. 


(;()IJ)    IXI.A\'S    AXIi    TllK    SIIJCA'I'KS    Oi;    I>()|:('KLA1X  lis.") 


A  Left  Upper  Lateral  Presextixg  a  Mesio-Labio-Lixguo- 
Incisal  Deficiency  Restored  to  Use  and  Cosmetic  Acceptable- 
NESS  BY  a  Cast  Gold  Inlay  and  Synthetic  Porcelain. 

Fig.  26L — A  lucsio-laljial  view  of  prepared  cavity. 

Fig.  262.— A  linguo-mesial  view  of  prepared  cavity. 

Fig.  263. — Wax  inlay  in  position  on  the  tooth,  provision  made 
for  synthetic  insert. 

Fig.  264. — Lingual  view  of  wax  inlaj'.  Note  extension  to 
tlio  right. 

Fig.  26.5. — Cavo-surfacc  view  of  wax  inlay.  Note  definition 
of  steps. 

Figs.  266  and  267. — Mesio-labial  and  linguo-mesio-ineisal 
views  of  finished  operation. 

Stress  Index:  Upward,  outward  and  liackward  or  iniraalvco- 
lar  Labio-Distally. 


28G  CAST    COIJ)    AND    Por.CELAlX    IXLAVS 

tlio  root  canal.  Tlu'  \\ax  iiiiiii(MliaU'l>-  surroiiiidiiii;'  tlic  post  ^^•ill 
soften  siifficiciilly  to  atlacli  itself  to  tlic  threads  upon  it,  and 
after  a  cold  water  s])ra\-,  post  and  inlay  may  be  removed.  ]f 
there  T)o  any  deticiency  to  tlie  wax  lin.nually,  the  (iiiaiitity  lack- 
ing- may  l)e  added  to  it.  fiday  and  post  are  ag'ain  replaced  in 
and  onto  tlie  tootli,  the  cai'vini;'  and  l)nrnisliing"  completed,  re- 
niembering  that  all  burnishing  nmst  be  done  in  the  direction 
of  the  margins;  the  Avax  is  rendered  smooth  with  the  cotton 
])(dlet  moistened  sparingly  with  oil  of  cajej^nt,  the  inlay  is 
carefully  but  firmly  held  in  joosition,  and  with  a  small  lance 
the  facial  i^art,  and  some  of  the  mesial  and  distal  surfaces  of 
it  are  removed,  leaving  a  box-like  simple  cavity,  presenting  a 
floor  and  four  walls,  the  gingival  wall  l)eing  formed  by  the  in- 
cisal  surface  of  the  tooth.  The  wax  inlay  is  now  carefully  re- 
moved, and  the  sjorue  wire  is  inserted  mesio-  or  disto-incisally. 
Tlie  sprue  Avire  is  placed  in  j)Osition  upon  the  crucible  former 
and  all  steps  necessary  for  proi:>er  investment  and  drying  out 
of  the  mold,  the  cooling  down  of  the  same,  and  the  casting  of 
the  molten  metal  into  this  mold  are  gone  through  as  descri))ed 
before. 

T'l^on  completion  of  the  casting,  it  nmst  be  subjected  to 
its  various  cleansing  and  neutralizing  baths,  carefully  finished 
and  polished  with  the  various  stones  and  discs. 

If  we  are  to  replace  the  facial  portions  with  a  silicate,  then 
the  boxlike  aperture  is  so  grooved  that  a  retentive  form  is 
obtained;  this  is  easily  accomplished  by  running  a  small  inverted 
cone  burr  along  the  incisal,  mesial,  and  distal  line  of  the  floor 
of  the  cavity  in  the  inlay. 

Jf  we  are  to  replace  the  facial  ])oi-tions  with  a  poi'celain 
inlay,  then  the  boxlike  aj)erture  in  the  cast  gold  inlay  must  be 
left  in  such  a  condition  that  no  undeiruts  are  present,  so  as  to 
facilitate  the  taldng  of  an  ini]ii-ession  of  the  facial  snrlace  of 
tlie  tootli  and  iiihiN'  ca\"ily  when  the  go  hi  in  Lay  has  been  cemeide(l 
to  ])lace. 

AVIkmi  the  gohl  iidaN"  has  heen  eompleteil,  the  fnbbei'  dam 
is  applieil  jiiid  the  casting  is  cemented  to  ])lace.  The  cemeid  is 
mixed  )-atlier  thin  bnt  well  spatulated  and  some  of  it  is  ])um))e(l 
U])  into  the  canal  by  means  of  a  .jilT.N'  tuhe  wln'n  the  casting- 
has  been  foj-ced  iido  ])Osi1ion  by  the  lingers,  it   i:<  tapped  geidly 


col. I)    l.N'LAYS    AND    TIIK    SIIJCATKS    Oi;    I'OIU'Kl.A  I  \  287 

willi  a  leal  1i('1'-('()\-('1'(m|  inallcl,  d  |-i\iii,L;-  a  (liill-|)()iii1('(l  iiisl  I'liiiiciit 
licid  against  llic  lingual  siiiTacc  in  a  lofwai'd  and  upwai'd  direc- 
tion. AVlien  the  ('('inciil  l)c,i;iiis  lo  set,  llic  poi'lioii  wliicli  lias 
1)0011  forced  inlo  llic  facial  hoxlikc  a])('itun',  is  removed  with 
an  oxcavatoi',  llic  inlay  hein^'  Indd  liinily  In  ])()sition  until  the 
cement  has  tliorou.L^lily  set.  Tlic  cimplc  ca\ily  now  ])resontinft- 
npon  the  facial  surface  of  tju;  ])artly  restored  tootli  may  he 
temporarily  tilled  \vitli  tlioiou^hly  softened  white  temporary 
sto])])!!!^'.  Xo  ])ressnre  shall  he  exercised  npon  this  stoppin^j,-, 
its  function  l)eiii<j,'  simply  to  occu])y  space  to  ])revent  the  iiigress 
of  food.  The  rul)her  dam  may  now  he  removed,  and  further 
o])eration  i^osti^oned  for  another  day. 

At  the  next  sitting',  the  ruhher  dam  is  af;ain  a])plie(l,  the 
tcmjjorary  stoj^jnu,:;-  is  removed,  tlie  hoxlike  cavity  is  thoroughly 
cleaned,  removing  every  trace  of  cement,  a  retentive  form  is 
l)rodncod  as  directed  and  the  cavity  tilled  with  a  silicate  cement. 

The  color  of  the  gold  must  he  taken  in  consideration  when 
the  silicates  are  emjjloyed,  for  these  cements  heiiig  markedly 
translucent,  will  allow  the  yellow  to  influence  their  shade  to  a 
great  extent,  so  much  in  fact,  that  if  a  hlne  surface  he  required 
it  will  he  best  to  place  a  thin  piece  of  i^latinnm  foil  n^Don  the 
floor  of  the  cavity  and  place  the  silicate  npon  that.  The  silicate 
must  he  kept  dry  for  a  period  of  twenty  minutes  to  one-half 
hour.  Some  paraffine  wax  may  then  be  thrown  over  it  and  the 
rubber  dam  may  he  removed.  In  another  fifteen  minutes,  or  at 
a  subsequent  sitting,  the  filling  may  be  polished  Avith  fine  cuttle 
fish  discs,  charged  or  lul)ricated  Avith  paraffine  or  cocoa  butter; 
a  beautiful  restoration  will  be  the  result. 

It  is  essential  that  the  metal  of  wliich  the  gold  portion  of 
the  restoration  is  made  shall  not  yield  or  flow  under  the  maxi- 
mum of  masticatory  stress,  because  if  it  does  the  cavity  filled 
with  the  silicate  will  alter  its  geometric  lines  to  an  extent  great 
enough  to  fracture  the  silicate.  For  this  reason  these  inlays  are 
cast  in  a  special  alloy  to  be  considered  later  on. 

If  a  fused  porcelain  inlay  is  to  comiolete  the  facial  joart  of 
this  anterior  restoration,  the  preparation  of  the  boxlike  cavity 
is  somewhat  different,  its  linear  extent  being  greater  at  the 
orifice  than  at  the  floor,  so  that  each  surface  of  the  cavity  shall 
form  an  obtuse  anii'le  of  about  100    with  the  floor. 


I'SS 


CAST    OOI.D    A  XI)    roitCHLAIN    IKLAYS 


Fior.    2(58. 


FJii.    -269. 


Fio-.    270. 


Fii--.   271. 


Fi-     27:!. 


ciOLi)  i>;lavs  and  tjiI':  siiJCAri:.s  on  poucelaix  289 


Views  of  a  Right  Upper  Central  PRfTsENTixG  a  Large 
Mesio-Labio-Linguo-Iincisal  Deficiency,  Restored  to  Use  and 
CosjiETic  Acceptableness  by  a  Cast  Gold  Inlay  and  Porcelain 
Insert. 

Fig.  268. — Mesio-labial  view  of  prepared  tooth.  Note  the 
obtuse  angle  at  median  line  of  the  gingival  seat  of  the  cavity  and 
the  acute  angle  between  the  mesio-labial  wall  and  mesio-gingival 
wall. 

Fig.  269.— Note  depth  and  definition  of  all  eavo-surfaciC 
angles,   pulp   not   involved. 

Fig.  270.— Mesio-linguo-gingival  view  of  prepared  tooth. 
Note  extension  of  cavity  linguo-gingivally,  the  acute  angle  created 
between  the  lingual  and  labial  plates.  This  acute  angle  extends 
from  the  incisal  end  of  the  cavity  to  its  extreme  liuguo-gingival 
apex. 

Fig.  271. — A  eavo-surface  view  of  the  prepared  wax  inlay. 
Fig.  272.— A  lingual  view  of  the  prepared  wax  inlay. 
Fig.  273. — Wax  inlay  in  position  showing  boxlike,  or  simple, 
cavity  for  porcelain  insert. 

Figs.  274  and  275.— Mesio-labial  and  linguo-mesial  views  of 
the  finished  operation. 

Stress  Index:  Upward,  outward  and  backward  or  intraalveo- 
lar  Labio-Distally. 


290 


CAST    (;()LI)    AXn    POIU'KLAIX     INr.AVS 


Y\(y.  276. 


Fio-.  277. 


ri".  278. 


Fiir.  279. 


Fii--.  280. 


Fi-    281. 


Ki-    2X2. 


coij)   l^•|.A^•s  :.s\)  tiik  silicates  ok   I'okcki.ai  x 


\'iiAv.s  OF  A  Lekt  Upper  C'extkal  ]'ke.sf.xtixg  a  Mesio-Disto- 
Labio-Ixcisal  Deficiexov,  Restored  to  Use  axd  Cosmetic  Ac- 

CEPTABLEXESS    BY    A    CAST   GOLD    IXLAY   AXD    SYXTHETIC    PORCELAIX 
IXSKRT. 

Fig.  276. — Laljial  view  di'  the  preparod  tootli.  Xotc  tlio 
lii'M'is  at  the  incisal,   mesial,   and  gingival  walls. 

Fig.  277. — Lingnal  view  of  the  prepared  tooth.  Xotc  large 
lievel  linguo-giiigivally,  and  central  keyed  groove  running  into 
root  canal  whicdi  has  been  filled. 

Fig.  278. — Lingual  view  of  the  wax  inlay. 

Fig.  279. — Cavo-surface  view  and  view  nf  prepaicil  laliial 
surface  of  the  wax  inlay. 

Fig.  280. — Wax  inlay  in  position  n])on  the  tooth,  wax  carved 
out  to  provide  for  porcelain  insert. 

Figs.  281  and  282. — Laliial  and  lingual  views  of  the  finished 
fiperation. 

Stress  Index:  Upward,  outward  and  liackward  or  iittnniJri  o- 
Jiir.  Labio-Distalta'. 


292 


CAST    GOLD    AXD    POPvCELATX    IXLAYS 


Fio-.  283. 


Fig-.  284. 


Fi"-.   28.5 . 


Fio-.   286. 


Fio-.  287. 


Fin.  288. 


Fi-r.  28<i. 


GOLD    INLAYS    AND    THE    SILICATES    Oil    POllCELATN  293 


A  Xl-.MI;KK  of  X'IKWS  of  a  IJiuIIT  I'I'I'KK  CKXTKAL  rKKSKNTIXti 
AX     EkODKD    AXI)    i'lTTFl)     LaUIAL     SLKFACE,     A     MKSIO-     -VXD    DlSTO- 

Pkoximal  Cavity,  axo  a  Lixcual  Examel  Surface  Which  "Was 
Pekfkct,  as  Was  the  Ixcisal  Edge. 

Fig.  28;]. —  Liiii;ii;il  view  of  pieparod  tooth.  Note  grooves 
linguo-distally  and  linguo-nicsially.  Note  linguo-mcsial  and 
linguo-distal  acute  angles. 

Fig.  284. — -Labial  view  of  2)repared  tootli.  Note  taper  toward 
the  incisal  edge.  Note  shoulder  at  the  gingivo-labio-distal  an({ 
mesial  portions  of  the  tooth  or  its  cervical  circumference. 

Figs.  285  and  28G. — Labial  and  lingual  views  of  the  wax 
inlay. 

Fig.  287. — Wax  inlay  in  positiim  (in  tlio  tooth  and  provision 
made   for   porcelain   insert. 

Figs.  288  and  289. — Linguo-incisal  and  laliial  view  of  fin- 
ished operation. 

Stress  Index:  Upward,  outward  and  backward,  or  intraaJvco- 
lar  Labio-Distally. 

The  question  will  come  up  as  to  why  a  complete  porcelain 
jacket  crown  or  a  cast  base  x)orcelaiu  crown  was  not  made  for 
tliis  tooth,  and  this  must  be  answered. 

I  hcUfive  that  (ill  jacl'ct  croicns  arc  injurious  in  so  far  as 
they  completely  cover  something  that  Xuttirc  7ncant  sliould  he 
exposed  to  aerobic  influence. 

Gold  is  more  ohjectionahle  than  porcelain  because  it  irritates 
the  liarmony  of  the  vis'ual  field;  but  a  gold  jaclcet  crown  does  no 
more  than  cover  up  the  organ  or  tooth. 

Cases  have  come  under  my  observation  and  treatment  where 
the  mere  removal  of  gold  and  porcelain  jacket  crowns  and  some- 
times the  polishing  of  the  remaining  portion  of  the  uncovered 
tooth  or  teeth,  more  often  the  excision  of  the  crowns  and  substitu- 
tion of  it  by  a  cast  base  crown,  have  done  away  with  such  func- 
tional dystrophies  of  the  central  nervous  system  as  loss  of  pati- 
ence, impaired  vision,  loss  of  memory,  and  general  irritability 
to    surroundings    which    before    seemed    perfectly    congenial. 


2[)4:  CAST    (lOLIi    AND    l'<  )i;('KI  ,A  1  X     IXLA\"S 


1  was  L^raiUiallv  tciiccil  t(i  rdrniulate  the  lolluwiiiy  laws  fur 
iHvsell'  as  a  guide  in  practice. 

J.  lliat  part  of  the  tootlt.  wliich,  covered  wilJi  enamel,  rises 
out  of  the  alveolar  soclcet  into  space  is  intended  to  live  in,  and 
hi  .■subjected  to,  r.rtra-acrohic  currents,  and  must  never  he  al- 
tni/i  tlnr  d<iiriv(d  of  this  a[ipari  iitli/  necessary  relationship. 

£.  One  is  justified  tn  excising  a  badly  broken-down  tootlt,  and 
covering  the  roots  of  the  tooth,  with  a  cast  base  crown  because 
th<    roof  is  not  in  normal  cases  exposed  to  extra-aerobic  influence. 

.!.  A  jacket  crown  is  harmful  and  unsafe  because  it  robs  all 
that  jiart  of  tlie  tooth  which  was  left  above  the  gum  of  its  bath 
in  the  sea  of  air  wliich  surrounded  it. 

4.  An  inlay  or  type  of  res.toration  heie  sliown  enables  the 
tooth  to  keep  up  its  relationship  Avith  the  air  by  virtue  of  the 
remaining  portion  of  enamel  upon  the  lingual  surface. 

5.  It  will  get  the  quantity  of  air  which  it  needs  through  the 
medium  of  this  small  part  of  itself  by  simply  taking  up  the  air 
more  rapidly,  even  as  a  man  who  has  been  walking  briskly  or 
running  gets  his  cjuota  of  oxygen  by  increasing  the  rate  of  his 
inspirations  and  e.\])irations. 

6.  In  inserting  a  filling  or  inlay  iirto  a  tootli,  it  is  safer  to 
cut  through  the  eiramel  and  inlay  the  dentine  than  it  is  to  partly 
cut  througli  the  enamel  and  seal  this  partly  cut  enamel  surface. 

7.  Tlic  enamel  of  the  teeth  comes  from  the  ectodcrmic  layer 
and  is  fiiinied  by  tlie  evolution  of  this  layer. 

The  central  ncrxiius  system  comes  from  tlie  eitodermie  Jaycn- 
and   IS    rf)rnied  by  tlie  iiivcdution   of  this  layer. 

8.  Constant  tropliic  irritation  of  any  ])art  of  tlie  enamel 
of  a  tooth  will  cause  a  di.sturbance  of  the  central  neivous  system. 

9.  Dejiriving  a  tootii  which  is  left  standing  in  the  oral  cavity 
of  its   re(|uired   aerobic  bath    is  a   constant  trojihic  irritation. 

10.  'I'his  is  the  reason  that  (dasps  are  dangerous  and  should 
hanlly  ever  or  never  be  used  uidess  tlie  ])art  of  the  tooth  witli 
which  it  conii's  in  contart  has  tn'rii  inlased  to  the  full  (h'|ifh  of" 
its  enamel    wall. 

11.  .\afurc  knows   best,  let   the  tooth    hieathe. 


(iOLI)    IXr.AVS    AND    TIIK    SI  LICA'I'KS    ()|;     I'olK 'lOLA  I X  1^95 

A  iiialiix  iiia>'  llicii  he  l)iii-iiisli<'(l  into  lliis  caNity,  and  the 
])()i'('('laiii  I'liscd  into  this  matrix,  oi'  an  ini])r(  ssioii  is  taken  ol* 
this  sim])h'  cavity,  an  amalgam  die  is  iiuuh'  as  desc'i-il)e{l  l)ero]'e, 
and  tlie  die  is  mounted  in  a  small  swa<;ini;"  en])  so  tliat  it  may  he 
])lace'd  in  a  small  Ajax  swa.u'e,  and  the  iiiati'ix  s\va,i;(Ml  into  and 
onto  the  die.  IJcfore  any  attem|)t  is  made  to  I'emoNc  the  matrix 
t'l'oin  the  ea\it\,  direct  or  from  tlie  die,  it  is  best  to  fill  the  matrix 
with  a  hit  of  wax  and  to  l)i'in,L:,'  this  wax  over  the  marf^'iiis  of  thci 
cavity  to  supplx'  an  ordinaril_\'  indcst rnct  ihle  oi"  unchan.^cahle 
i'i<;'idity  to  tlie  matrix. 

Tlie  matrix,  cai'ryiii*;'  the  wax,  is  then  invested  in  a  paste 
ol;'  silex  and  watei",  or  <i,'ronnd  asbestos  and  water,  and  care  is 
taken  to  so  tack  the  ])latinum  around  tlie  mai'K'nis,  that  it  will 
])i-()ve  ditlRcult  for  it  to  warp;  with  tliis  end  in  view  the  margins' 
may  be  curled  downward  so  that  the>'  be  securely  held  a,i;ainst 
displacement. 

The  thinner  the  j)latinuin  foil  used  for  the  matrix,  and  the 
greater  the  care  given  to  the  swaging  of  it,  the  more  perfect  a  fit 
will  1)0  ohtained.  For  this  reason  a  foil  of  V-^noo  of  an  inch  in 
thickness  is  used,  and  this  is  carefully  ada])ted  to  the  floor  of 
the  cavity  with  a  ])ellet  of  cotton,  held  in  the  foil  carriers,  the 
ends  of  wdiich  sliould  be  rounded.  'I'lie  size  of  the  pellet  of 
cotton  is  gradually  increased,  until  it  is  large  enough  to  force 
the  i^latinum  foil  along  the  floor  of  the  cavity  towards  the  walls 
and  margins. 

The  writer  considers  the  safety  depth  or  retention  depth 
for  these  cavities  to  he  no  less  than  1  mm.  and  they  should  l)e 
no  less  than  l'('  to  '2  mm.  in  depth;  any  depth  greater  than  the 
latter  uselessly  endangers  the  integrity  of  the  foil. 

After  the  more  or  less  comjjiete  ada])tation  of  this  foil,  the 
floor  and  walls  of  the  cavity  in  the  die,  the  l)uinishers  are  used 
to  marginally  outline  the  cavity,  the  margin  of  necessity  pre- 
senting a  smooth  unl)uckled  a])])earance. 

The  swaging  cu])  holding  the  die  and  the  matrix,  may  then 
be  placed  in  the  loose  end  of  the  swagei',  a  rubber  dam  disc  is 
l)laced  over  the  matrix,  and  the  ])iston  of  the  swager  is  struck 
two  or  three  sniait  l)I()ws  w  itli  a  large  horn  mallet. 

r])on  examination  the  matrix  will  be  found  to  have  become 
2)erfectly  adai)ted  to  the  cavity  in  the  die.    As  said  before,  this 


296 


CAST  GOLD  AND  PORCELAIX  INLAYS 


Fig;.    290. 


Fig-.   291. 


Fig.  292. 


Fiff.  293. 


□Q 


Fig.  294. 


Fitr.  29.J. 


Fiff.  290. 


GOLD    INLAYS    AND    TIIK    SILICATES    OR    TOIICELAIN  297 


Sevkx  Views  of  Another  Type  of  Restoration"  in  an  Upper 
Cuspid.  The  Formation  of  the  Cavity,  the  Acute  and  Obtuse 
Angles  are  Clearly  to  be  Seen  in  Figs.  290  and  291. 

Figs.  292,  293,  aud  294  arc  views  of  the  inlay  in  and  out  of 
the  tooth. 

P^igs.   29.5   and   296   are   views   of  the   finished   operation. 

Stress  Index :  Uj^ward,  out  and  forward  and  out  and  back- 
ward or  intraalvcolar,  Labio-Mesially  and  Labio  Distally. 


298 


CAST    COLD    AN'D    I'OIH'KI.AIX    INLAYS 


Fi2-.  211 ; 


Fi2-.   298. 


Fi.M-.   299. 


Fip-.  300. 


Via.  :!(ii. 


Fiir.  ;502. 


Ki-.  ;;(i; 


GOI.If     INLAWS    AND    'I'lIK    SllJCATKS    OK     I'(  )i;( 'Kl -A  I  X  l!I)!) 


.Skvkx  Views  of  a  EiciHT  Upper  Cispid  Pkicskxting  a  Pke- 
hex.so-Labio-Lixgl'o-Mesial  Deficiency. 

Note  carefully  in  Figs.  297  and  298  tlio  fornuitiou  <if  the 
cavity  and  the  grooves  for  retention,  and  in  Figs.  299,  300,  and 
301,  views  of  the  wax  inlay  in  and  out  of  the  tooth.  Figs.  302 
and  303  are  views  of  the  finished  operat'ou. 

Stress  Index:  Ui)ward,  out  and  forward  and  out  an<l  liack- 
ward  or  intraalvfolar,  Labio-Mesially  and  Labio-Distally. 


300  CAST    GOLD    A2s^D    POrvCELAIA^    INLAYS 

matrix  imist  now  be  iilled  Avitli  some  ^vax,  and  tlie  Avax  nmst 
overlap  the  margins  of  it,  so  that  upon  removal  of  the  matrix 
from  the  die,  no  distortion  is  joossible. 

Upon  investment  of  the  matrix  as  described,  and  upon  dry- 
ing out  of  this  investment,  we  sliall  be  ready  to  burn  out  the 
wax  and  to  biscuit  and  fuse  our  porcelain. 

This  one  i^roblem  has  been  vexing  and  irritating  the  dental 
l^rofession  ever  since  i^orcelain  first  made  its  appearance  as  a 
filling  material,  and  unquestionably  the  inability  of  the  general 
man  to  solve  the  riddle  is  responsible  for  the  fact  that  porcelain 
is  so  sparingly  used  for  inlay  work,  even  when  strongly  in- 
dicated. 

These  men  who  have  been  teaching  porcelain  inlay  work 
and  jDorcelain  work  in  general,  the  men  who  have  written  about 
its  manipulation,  its  advantages,  the  indications  for  its  use,  and 
the  contraindications,  never  troubled  themselves  or  the  student 
much  al)out  the  color  problem,  and  left  that  to  the  commercial 
house  to  solve,  an  error  fraught  with  dire  consequences  to  the 
innnediate  future  of  ceramics  in  dentistry. 

The  reason  for  all  this  is  to  be  found  in  the  condition  that 
men  have  been  teaching  this  art  without  comprehending  just 
how  important  a  part  the  color  problem  plays  in  it,  and  the 
men  avIio  have  been  learning  the  art  failed  in  turn  to  realize 
that  to  their  ignorance  of  the  relation  existing  between  different 
colors  and  of  the  results  to  be  obtained  when  these  relations  are 
made  use  of  in  various  joroportions  is  due  their  lack  of  success 
in  porcelain  restorations. 

Xo  matter  how  charita1)ly  we  may  wish  to  look  uj^on  it,  we 
are  forced  to  the  conclusion  that  there  has  been  woeful  aimless- 
ness  about  this  branch  of  our  work;  we  have  tried  for  years 
to  do  somctliiiig  without  being  in  possession  of  the  necessary 
gi'ouiidwork'  k-iiowlcdgc  of  that  wliicli  in  a  great  measure  would 
luive  proved  the  key  to  our  success. 

Kealizing  that  othei-  j)liases  of  the  ceramics  as  applied  to 
dentistry  Jiave  been  sufficiently  enough  elaljoratcd  upon  by  other 
investigators  and  teachers  to  ])o  (juite  clearly  understood  by 
those  who  read  lliis  noIuiiic,  I  will  here  confine  myself  to  a  more 
or  less  fragmejilaiy,  l)ut  iicvcitlieless  pointed  and  easily  grasped, 
c'Xl)hiiiation  of  this  phase  of  the  art,  which  I  feel  has  been  neg- 


(!0L1»    IXlvAVS    AND    TIIK    SILICATKS    Olt     l'(  )|;('KLAI  X  301 

lecU'd  by  iiiV('sli;j,atoi's,  and  is  little,  if  at  all,  lURlcrslooil  l)y  the 
general  practitioiiei-. 

SUMMARY  FOR  CHAPTER  XIX 
Gold  Inlays  and  the  Silicates  or  Porcelain 

1.  In  Avhat  cases  is  the  restoration  of  incisal  edges  by  inlays  in  conjunction 
■with  porcelain  preferable  to  the  excision  of  the  tooth? 

1'.  Describe  the  preparation  of  a  root  canal  to  receive  a  post  and  give  the 
gauges  of  the  posts  used  in  the  various  teeth. 

3.  Give  the  rules  in  the  use  of  posts. 

4.  Describe   the   taking   of   an   impression   for   a   silicate   insert. 

5.  Describe  the  cementation  of  the  inlay,  the  choice  of  color  and  the  mak- 
ing the  silicate  filling. 

6.  How  would  you  prevent  the  fracture  of  the  silicate  insert  in  a  tooth 
subject   to  material   stress? 

7.  Describe  the  making  of  the  porcelain  insert. 


CHAPTEI?  XX 
THE  PHEXCBIEXA  OF  IJdHT  AXD  (H)T.()K 

Tlie  o-eneral  doctrine  oT  that  lonn  of  radiant  energy  known 
as  liglit  is  now  only  a  part  of  tlie  general  tlieory  of  radiation, 
wliicli  comprises  radiant  lieat  and  actinic  and  electric  radiation; 
but  since  tlie  l)attle  as  to  tlie  nature  of  radiation  in  general  was 
first  waged  ai'ound  light  itself,  it  is  convenient  to  consider  light 
as  representing  all  the  forms  of  radiation. 

By  elementary  observation  it  is  found  that  liglit  travels  (in 
a  uniform  medium)  in  straight  lines  in  all  directions;  that  is, 
M"hen  proceeding  from  a  j^oint  or  a  very  small  source  covers 
areas  which  vary  as  the  squares  of  the  distance,  and  that  shad- 
ows obey  a  similar  law. 

Light  is  seen  some  time  before  the  corresponding  sound  is 
heard.  The  most  common  illusti-ation  of  this  may  be  found 
during  any  thunder  storm,  the  lightning  being  visil)le  long  be- 
fore the  sound  of  thunder  reaches  the  ear. 

All  this  points  to  a  rapid  jiropagation  of  something  in 
straight  lines.    Is  it  inatter,  motion,  or  condition? 

The  simplest  explanation  was  that  luminous  bodies  emitted 
sometliing  material  whose  impact  affected  the  sensitive  eye; 
that  the  reflection  of  light  at  surfaces  was  due  to  elastic  rebound 
of  these  quick  traveling  matei-ials.  These  prenomena  might 
be  (Hiually  as  well  exj)laiiie(l  by  waves  traveling  and  being  re- 
ilecte<l. 

Sir  Isaac  Xewioii  could  not  I'cconcile  himself  to  the  opinion 
of  waves  1ra\-eling  ])asl  obstacles  and  not  s])i-eading  behind 
tlieni.  This  seeming  anomaly  le(l  him  to  ad()))t  and  develop  the 
cor];usecular  oi'  emission  11ieoi-\'  of  light.  Accoi'ding  to  this,  all 
luminous  ))odies  emit  with  e(|ual  xclocities  a  number  of  elastic 
coi'])Usc]es  tli;i1  1i;ivel  in  sti-aight  lines,  are  i-e(lecled,  and  ai'e 
refracted  at  the  suiTa<'c  se|)aratiiig  two  media.  IJays  of  Avhite 
light  when  refi'acte(i  aic  geneiallx'  dis])erse(l,  owing  to  the  con- 
stituents havin;^-  <lilferent  i-efractixc  ind.ici's. 


I'll  i':\(i.\i  i';x.\   oi'   LKiirr  axu  coloi;  .>().) 

I^'or  the  ordinal)'  idiciioiiiciia  of  rcllcci  Ion  and  icrract  ion  llic 
cinissioii  theory  was  siifficicnt  ly  sal  islaclory,  hut  in  oi'dcr  to 
('xj)laiii  the  plicnoincna  of  rcrraci  ion  and  i»olari/a1  ion,  IIic  theory 
hccaiiic  ()\('i'h)ad(Ml  with  a  mass  ol'  hypotheses.  Xewlon  niahi- 
taiiied  tliis  theory  to  the  time  ol"  Sii'  Dax'id  I>i-ewster. 

The  Ava\('  theory  ol"  linlit  was  sii,i;-,i;('sted  hy  (li-imahli,  I  look' 
and  others,  used  hy  1 1  iiy^ciis  (  KiTS)  to  exphiiii  (h)iihh'  i-et'rac- 
tiou;  it  had  few  s])()iisors  when  re\i\'e(l  hy  ^'o^lll,^■  in  tlie  l)e<;iii- 
iiiiii;'  of  the  nineteenth  century.  It  ^\■as  more  Fully  reeo<;nized 
and  its  ])heiioiiiena  made  clear  hy  'rresiiel  in  ISIo,  and  on  and 
until  it  liiiall_\'  and  dednitely  sni)planted  the  emission  theory. 

Accordin<;'  to  this  tlieory,  li^ht  consists  ol'  vihrations  in  an 
all  pervadin*;-  elastic  etliei',  and  these  vihrations  ai'e  in  direc- 
tions at  ]-i,i;lit  ani;'les  to  tlie  directions  ol"  ])r()])a.i;ation ;  and  "rays 
ol*  light"  are  mere  lines  showing'  the  direction  of  ])roj)agation 
of  (and  in  isotropic  media  at  right  angles  to)  the  corresponding 
])ortions  of  the  wave  front. 

The  wave  theory  readily  exi)lains  refraction;  in  refracti(Ui 
it  assumes  that  the  waves  travel  less  ra])idly  in  the  denser 
medium  (which  is  found  to  he  true)  and  it  ex2)lains  the  accom- 
])anying  reflected  wave;  it  explains  douhle  refraction,  polariza- 
tion, ahsorption  of  light,  interference,  color  and  complementary 
colors,  diffraction,  etc.  All  these  plienomena  are  explicable  as 
j)lienomena  of  rhythmic  disturbance  of  some  kind  and  the 
wave  tlieory  really  goes  no  further  than  to  state  this.  The 
rhythmic  disturbance  may  be  one  of  position,  wave  motion,  of 
stress,  of  electrical  condition,  possibly  a  twist  in  the  ether. 
Clerk  Maxwell  holds  that  every  portion  of  the  ether  in  the  j^atli 
of  a  beam  of  light  is  subject  to  rapidly  alternating  stresses 
transverse  to  the  ray,  and  is,  thei'efore,  in  a  ra])idly  alternating 
electric  and  also  in  a  ra])i(lly  alternating  magnetic  condition, 
and  the  curious  relation  now  known  to  exist  between  beams  of 
light  and  the  field  of  force  of  a  magnet  lends  su])])ort  to  this 
theory.  The  experiments  of  Hertz  tend  to  ])rove  that  all  the 
])henomena  of  light,  radiant  heat  and  actinic  radiation  are  re- 
(lnc(Ml  to  phenomena  of  electro-magnetic  radiation  between  cer- 
tain limits  of  wave  length. 

Although  these  facts  hav(^  iio  ini])ortant  or  direct  bear- 
ing on  tlu^  sul)i(H't  involved,  it  mav  he  of  interest  to  note  that 


304  CAST    GOLD    AXI)    PORCELAlX    IXLAVS 

the  velocity  of  light  was  iirst  round  hy  llimiiis,  the  eclipses  ot 
Jupiter's  satellites  when  they  were  at  the  greatest  and  the  least 
distance  from  the  earth;  but  it  can  be  measured  in  the  labora- 
tory by  a  purely  experimental  method.  The  mean  of  all  ob- 
servations is  that  light  of  all  Avave  lengths,  travels  in  vacuo 
with  a  velocity  of  30,057,400,000  centimeters,  or  186,772  meters, 
jjer  second;  in  air  with  a  velocity  less  than  this  in  the  ratio 
of  10,000  to  10,003.  The  length  of  waves  can  be  ascertained 
from  measurement  at  adecjuate  distance  to  the  fringes  produced 
by  interference,  or  by  the  use  of  diffraction  gratings  ruled  with 
a  known  large  number  of  lines  to  the  inch  (40,000  or  more). 

The  wave  lengths  of  radiant  heat,  light  and  actinic  radia- 
tions range  from  1/660  cm.,  or  1/16,500  in.  (the  longest  invisible 
heat  rays  lengthwise)  to  1/1,300,000  cm.,  or  1/62,500,000  m. 
(visible  actinic  rays;  the  visible  limits  are  1/13,042  and  1/25,186 
cm.  The  frequency  or  number  of  weaves  per  second  accordingly 
range  from  20  million  per  second,  the  extreme  visible  limits 
being  392  to  757  million  of  millions  per  second. 

In  optical  instruments  a  pencil  of  rays  sometimes  deviates 
from  the  point  through  whicli  every  component  ray  of  the  pen- 
cil should  pass.  Spherical  aberration  results  from  the  spherictiy 
of  length  surface  or  of  the  mirror  used  to  produce  the  image 
of  the  object.  Chromatic  aberration  is  due  to  the  different  re- 
frangibilities  of  the  components  of  white  light.  Eef.:  Tait, 
Glazbrook,  Stokes,  Preston  and  AVood  on  Light  and  Optics. 

REFLECTION  AND  REFRACTION  AND  ABSORPTION 

A  surface  on  which  a  l)oaiii  of  light  falls  may  be  either 
rough  or  smooth.  If  it  be  rough,  the  greater  part  of  the  inci- 
dent light  is  irregularly  scattered  by  the  innumerable  surface 
facets,  to  be  reflected  or  dispersed  in  all  directions;  if  it  be 
smooth,  a  proportion  (never  the  whole)  of  the  incident  light 
is  regularly  reflected  or  turned  back  in  denfiite  paths.  A  smooth 
dustless  mirror  is  not  visible  to  the  eye  outside  the  track  of  rays 
reflected  from  it.  If  that  polished  surface  be  that  of  a  trans- 
parent substance  (like  glass)  optically  denser  tlian  the  medium 
conveying  the  light  of  it,  compai'atively  little  light  is  reflected: 
The  more  oblique  the  incidence,  the  smoother  the  polish,  and 


PIIKXO.MKXA    OK    I.KJII'l'    AXJ)    COLOIt  305 

tlie  greater  the  (lirrci-ciicc  hctwccii  the  ()])ti('al  density  of  the 
glass  and  tliat  of  the  medium  in  which  it  is  immersed,  tlie 
grealei'  will  he  the  ])i'()p()i-li()ii  reflected.  Less  liglit  will  he  i-e- 
flected  from  glass  under  water  than  will  he  reflected  from  the 
same  glass  in  air. 

If  the  light  travel  in  a  denser  medium  and  strike  the  hound- 
ing surface  l)etween  it  and  tlie  rarei-  medium,  as  where  light  is 
ascending  through  water  and  strikes  its  npix'r  free  surface,  it 
will,  if  its  o))liquitY  of  incidence  exceed  a  certain  limit,  he  al- 
most totally  reflected,  the  small  loss  that  ensues  arising  wholly 
from  absorption  while  no  light  is  transmitted  into  the  air  ahove. 

On  reflection  from  i^olished  surfaces  we  have  so  far  as 
regards  the  directions  of  the  reflected  rays  the  following  laws: 

1.  The  incident  lay,  the  normal  (i.  e.,  a  line  drawn  per- 
pendicularly) to  the  surface  at  the  point  of  incidence,  and  the 
reflected  "ray"  all  lie  in  one  plane,  the  plane  of  "incidence." 

2.  The  angle  of  incidence  (the  aiigle  which  the  incident  ray 
makes  with  the  normal  to  the  reflecting  surfaces)  is  equal  to  the 
angle  of  reflection  (the  corresponding  angle  between  the  normal 
and  the  reflected  "ray"). 

These  laws  ai^ply  equally  to  ether  waves  of  all  lengths,  and 
therefore  to  light  of  all  colors,  no  matter  what  the  shape  of  the 
surface  may  be. 

1.  Uays  which  are  parallel  to  one  another  l)efore  striking  a 
plain  reflecting  surface  are  jiarallel  after  reflection. 

2.  If  light  diverging  from  or  converging  towards  a  point 
l)e  reflected  from  a  plain  mirror,  it  will  appear  after  reflection 
to  diverge  from,  or  converge  towards  a  point  situated  on  the 
opposite  side  of  the  min-or  and  at  an  equal  distance  from  it. 

In  curved  reflecting  surfaces  we  inust  trace  out  the  mode 
of  reflection  of  incident  rays  from  each  element  or  little  bit  of 
the  reflecting  surfaces;  and  through  geometric  workings,  we 
arrive  at  the  following  propositions: 

1.  Parallel  rays  traveling  parallel  to  the  axis  of  a  con- 
cave paraboloid  mirror  are  made  to  converge  so  as  to  actually 
pass  accurately  through,  i.  e.,  the  geometric  forms  of  the  para- 
boloid; and,  of  course,  if  the  course  of  light  be  at  the  focus,  the 
rays  reflected  from  the  niii'ror  emerge  ])ai'allel  to  one  another. 


306  CAST    GOr.D    AXD    PORCELAIN    IXLAYS 

In  sijlierical  rclk'c'tioiis  tlu'iv  is  no  acciirali'  roeiis  except  for 
I'ays  proceed iiiii,'  from  the  center  aiul  ]-etiirniii,i;'  to  it. 

AVlien  these  reHections  are  small  as  compared  to  the  dis- 
tance ot  the  center  of  curvature,  they  act  approximately  like 
])ai'al)olic  reHeclors  for  ])arallel  rays. 

liays  2:)aralk'l  to  tlie  axis,  that  is,  rays  from  a  distant  source 
of  light,  are  reflected  so  as  to  pass  through  the  princij^al  focus. 
Concave  juiirors  act  like  concave  lenses. 

Refraction 

AVlien  a  l)eam  of  light,  traveling  in  a  transparent  medium, 
imi:)inges  ol)liquely  ni:)on  the  surface  of  another  transj^arent 
medium,  a  part  of  the  light  is  reflected,  and  a  jDart  of  it  enters 
the  second  medium,  hut  in  so  doing  it  is  refracted  or  hent  ont 
of  its  former  course.  The  incident,  reflected,  and  refracted  rays 
lie  in  one  j^lane. 

Snell,  in  1621,  elucidated  the  following  law  of  refraction. 
''The  sine  of  the  angle  of  incidence  ])ears  to  the  sine  of  the 
angle  of  refraction  a  ratio  which  remains  constant  for  any  two 
media,  whatever  be  the  angle  of  incidence." 

This  law  of  refraction  is  an  immediate  deduction  from  the 
])roperties  of  wave  motion;  if  we  assume  that  the  speed  of  j)roim- 
gation  of  light  is  different  in  the  different  ]nedia.  When  a  wave 
23asses  over  the  surface  of  water,  the  direction  of  propagation 
is  perpendicular  to  the  crest  or  throngh  the  wave  motion.  In 
like  manner  we  iiuagine  the  ray  of  light  to  he  j^erpendicnlar 
to  Avhat  is  called  the  wave  front,  which  ^^ropagates  itself  throngh 
the  medium  with  the  speed  of  light.  So  long  as  the  light  is 
confined  to  one  and  ilie  same  medium,  any  wave  front  on  Avhich 
we  fix  our  attention  will  travel  forward  so  as  to  ever  he  ])arallel 
to  its  original  position. 

In  Fig.  304  let  AxVA"  i-epresent  one  of  a  pencil  of  rays  im- 
pinging ohrKjudx'  on  the  sni'face  !>.  I'he  wave  IVont  may  be 
repi-esentcil  l)y  a  line  tlii-ough  A  j)ei-peiidicular  to  the  direction 
of  pi'o])agation.  At  the  end  of  a  certain  time  the  Avave  front  is 
at  A' ;  aftei-  aiiothei-  int»'i'\al  of  e(|ual  duration  it  is  at  A".  Dur- 
ing tlie  next  e(|ual  interval  of  time,  a  graduall>'  diminishing 
breadtJi  of  wave  is  ti-aveliiig  the  oiigiiial  medium  with  the 
original  sjjeed;  while  a  steadily  widening  portion  of  the  wave 


I'll  KNo.M  i':.\'A  (»!■'   l,i(;iri"  anh  coi.oi;  ,*>()( 

ri'oiil  is  ciilcriii^'  ilic  second  iiKMliiiin.  IF  we  suppose  ilie  s])ee(l 
of  prop;i,L;at  ion  of  llie  disl  inhnnc'  to  ))e  less  in  the  second 
incdimn,  it  is  clear  that  the  <'iid  A.  which  lias  Ix'cii  ti'av('liii<»- in 
the  second  mediiim,  whil"  the  end  A"  has  still  been  in  the  first 
mediiiin,  must  have  ti"a\"eh'(l  ovei-  a  sliortei-  distance,  'i'lic  wave 
i'l'ont  through  A  will  then  pi-oceed  to  in()\'e  in  the  second  mo- 
cliiiin,  so  as  always  to  I'emain  j)aiallel  to  its  ori<;-iiial  direction 
ill  this  inediuin,  hence  the  lel'iacted  wave  front  moves  on  at  a 
less  iiKdination  with  the  interface  se])aratin<'-  the  media  than 
that  with  which  the  original  wave  front  imi)in<;ed  n]>oii  tlie  in- 
terface. A,i;ain  the  distance  ot  A"  from  the  surface  JJ,  as  meas- 
nr(Hl  aloiiii'  the  ra\'  will  ))e  greater  than  the  distance  from  the 


Fjo-.  304. 


same  surface  as  measured  alon^-  the  ray,  in  the  ratio  of  the 
speeds  of  proj^agation  in  the  two  media. 

This  ratio  is  the  ratio  of  tlie  sines  of  the  angles  of  incidence 
and  refraction  as  given  in  SnelTs  law,  and  is  caUed  the  refrac- 
tive index  of  the  second  medium  as  compared  with  tlie  first. 
Thus  physically,  the  refractive  index  of  any  transi^arent  medium 
is  the  ratio  of  the  speed  of  propagation  of  light  in  empty  ether 
to  its  speed  in  the  medium,  the  medium  in  which  light  travels 
more  slowly,  is  said  to  liave  tlie  greater  optical  density. 

If  we  regard  A  A'  to  he  the  original  ray  traveling  in  the 
denser  medium  being  refracted  as  A" A' A  in  the  less  dense 
medium,  we  just  reverse  the  direction  of  the  rays  without  any 
change  in  the  relation  of  the  angles,  except  that  the  refractory 


308  CAST    COLD    AND    POlU'Er.AlX    i:M.AYS 

ra\'  is  now  IxmiI  ;n\;iy  from  llu>  normal  or  ixM-pcndiciilar  to  the 
surface.  Ima^-iuc  the  incident  ray  in  tlie  denser  medium  to  be- 
come more  and  Jiiore  oljlique  to  the  interface,  the  refracted  ray 
Avill  tend  uiore  and  more  to  paralk'lisni  ^vith  the  interface,  and 
linally  for  a  dehnite  inci(h^nce  will  pass  alonij,'  it. 

For  liigher  incidence  than  tliis  critical  an^ie,  no  refracted 
ray  will  pass  out;  the  light  will  l)e  wlioUy  reflected  witliin  the 
denser  medium  leaving-  out  of  account  wliat  is  absorbed  at  the 
interface.  Tliis  angle  is  the  angle  of  total  reflection  or  the 
critical  angle. 

Absorption 

If  a  ray  of  sunlight  l)e  allowed  to  fall  upon  a  glass  prism, 
it  will  be  found,  on  emerging,  to  be  split  up  into  a  color  band, 
which  is  called  the  solar  spectrum.  Conversel}^,  these  colors, 
when  combined  produce  ordinary  white  light;  most  substances 
when  ex])osed  to  sunlight  have  the  power  of  reflecting  one  or 
more  of  these  coloi's,  and  of  absorbing  the  rest.  Thus,  if  a 
ray  of  sunlight  falls  on  a  patch  of  grass,  the  grass  absorbs  all 
the  colors  of  the  white  light  except  the  green,  which  it  reflects. 
These  reflected  rays  meet  the  eye  and  convey  to  it  a  sensation 
of  greenness;  and  hence  the  grass  appears  as  a  substance  green 
in  color.  Similarly  a  poi^py  is  red,  because  it  absorbs  all  the 
rays  except  the  red,  which  it  reflects,  and  thus  assumes  a  red 
hue.  \n  the  case  of  a  white  flower,  none  of  the  colors  of  the 
s])(H'trum  ai-e  absorbed;  all  are  reflected.  On  the  other  hand, 
a  l)lack  cloth  absorbs  all  of  the  rays  and  reflects  none  of  them, 
and  so  appears  black.  A  red  liquid  or  glass  transmits  only  the 
rays  at  the  red  end  of  the  spectrum  and  absoi-bs  the  others,  and 
so  wilh  the  otlici-  coloi's.  A  cobalt  blue  glass  transmits  only 
bluf  rays,  and  the  extreme  red  rays,  while  a  glass  colored  red 
with  copper  oxide  absoi'bs  llie  ])lue  and  transmits  the  red.  If 
then  these  two  glasses  be  j)lac(M|  one  in  fi-ont  of  the  other,  and 
oi-dinary  white  light  he  allowed  to  fall  u])oii  them,  the  combina- 
tion ])erinits  only  the  exii-eme  I'ed  rays  to  reach  the  eye,  thus 
producing  a  vei-y  ])ni-e  deep  icd.  This  method  of  combining 
different  absorl)ing  media  is  employed  to  ol)tain  definite  coloi-s 
in  purity;  thus  while  light  ])assing  through  these  cells,  one  con- 
taining aniline  Mnc,  one  eliromale  of  potash,  and  one  coi)2)er  or 


PJIEXO.MEXA    OF    I.ICllT    AND    COLOIl  oi)[) 

Hiil])liat(',    is   successively  robbed    of   its    bbie,    yeHow,    and    r^'d 
rays,  and  the  eiiiei'^'eiit  li,i;lil  is  pure  green. 

'Phe  absorj)iion  of  li^ilit  by  ♦••ases  follows  a  dilTerent  biw. 
Tht'  while  li<;hl  falls  on  a  cool  ,i;as,  the  <;'as  absorbs  only  those 
i-ays  which  it  wouhl  itself  emit  if  incandescent,  and  leaves  dai'k' 
lines  in  their  ])laces  in  the  s])ectruin  of  the  light.  The  vapoi'  of 
sodium,  which  is  yellow,  when  incandescent  absoibs  yellow  rays, 
when  cool.  On  the  other  hand,  if  the  gas  be  incandescent,  ab- 
sorption still  takes  place,  but  the  light  of  the  gas  is  sul)stitute(l 
in  the  spectrum  for  the  light  absoibcd,  ])roducing  a  l)right 
yellow"  band  there. 

The  color  band,  called  the  solar  spectrum,  is  found  u])on 
examination,  to  be  crossed  by  a  number  of  dai'k  lines.  Jf  the 
source  of  light  be  changed,  the  spectrum  changes  with  it.  In 
the  siDectrum  of  the  wdiite  light  of  a  candle,  for  instance,  or  that 
of  the  oxyhydrogen  lime  light,  the  dark  lines  vanish  and  we  have 
a  continuous  spectrum.  Again,  if  light  from  an  incandescent 
gas  or  vapor  be  examincMl,  we  get,  in  general,  a  sj^ectrum  con- 
sisting of  a  clehnite  number  of  bright  lines  on  a  dark  ground. 
Every  gas  or  vapor  yields  a  different  and  quite  characteristic 
spectrum.  The  salt  of  sodium  l)nrned  in  a  Bunsen  flame,  will 
cause  the  flame  to  become  yellow^,  and  the  spectrum  consists  of 
two  narrow  lines  of  yellow^  light.  Similarly  potassium  gives  a 
violet  flame,  and  two  In'ight  lines  in  the  red  and  one  in  the  violet 
of  the  solar  spectrum.  Strontium  colors  the  flame  red,  and  has 
a  number  of  lines  in  the  red,  one  in  the  orange  and  one  in  the 
blue  ijortion  of  the  spectrum. 

Though  perhaps  having  no  direct  bearing  upon  the  color 
problem  as  it  concerns  our  su])ject,  it  is  of  interest  to  note  that 
these  bright  lines,  in  the  si^ectrum  of  the  various  substances 
mentioned,  correspond,  in  position,  to  certain  of  the  dark  lines 
of  the  solar  spectrum,  and  it  has  l)een  estal)lislied  that  the  dark 
lines  indicate  the  jjresence  of  these  metals  in  question  in  the 
sun.  As  said  ])efore,  when  white  light  falls  on  a  relatively  cool 
gas,  the  gas  absorbs  these  rays  that  it  would  itself  emit  in  incan- 
descejice.  Thus  \\-e  might  liax'e  in  a  room,  a  source  of  liglit 
giving  out  all  ])()ssil)le  waves  of  light,  fi-oni  red  to  violet.  If 
this  light  were  h^d  through  a  screen  of  sodium  vapor,  the  screen 
would  absorlj  those  rays  wdiose  wave  lengths  corresponded  to 


310  (.'AST    COl.D    AND    TOIU'ELAIX    JXLAVS 

tlie  bright  sodium  linos  in  tin,'  Yellow  ])art  of  the  spectrum. 
These  rays  l)eing  removed,  there  would  be  left  two  dark  lines 
in  their  pUices.  This  is  precisely  what  happens  in  the  case  of 
solar  si)ectrmn.  The  sun  is  a  source,  giving  out  light  of  all 
l)ossible  wave  lengths;  as  the  light  passes  through  the  sun's 
atmosijhere,  it  encounters,  say,  the  vajDor  of  sodium.  This  vapor 
absorbs  the  rays  whose  wave  lengths  correspond  to  the  yellow 
lines  of  the  sodium  spectrum  and  leaves  dark  lines  in  their 
])laces  in  the  solar  spectrum.  By  observing  these  ahsorj)tion 
lines  in  the  solar  and  stellar  spectra,  the  jjresence  of  various 
terrestrial  elements  have  been  proved  in  the  sun  and  the  stars. 

The  refractive  index  of  a  transi)arent  medium  is  different 
for  different  kinds  of  light.  "When  white  light  passes  through  a 
jjrism,  the  diiferent  colored  rays  of  which  it  is  composed  are 
bent  at  varying  angles  from  the  original  conunon  source  of 
direction. 

They  are  said  to  be  disj)ersed.  The  disi^ersion  for  the 
given  prism  depends  upon  the  difference  of  the  refractive  in- 
dices of  the  extreme  rays  of  the  visible  spectrum.  It  A^aries 
with  the  substance  and  the  angle  of  the  ])rism.  In  general  rays 
of  short  wave  length  are  more  refracted  than  rays  of  long  wave 
length,  but  in  some  refracting  media  this  law  partly  breaks 
down,  and  the  dispersion  is  then  known  as  anomalous  disper- 
sion. (Ref.:  Schellenon,  "Spectral  Analyses,"  Marshall  AVatts, 
' '  Spectrum  Analysis, ' '  Baly,  ' '  Specroscopy. ' ' ) 

The  impact  of  ether  waves  of  a  certain  particular  frequency 
induces  in  the  eye  a  particular  color.  Color  then  is  a  sensation 
and  really  has  no  material  existence. 

The  eye  can  recogni/.e  no  other  waves  save  lliose  having  a 
fi'equeucy  of  from  'M)'2  to  T-")?  billion  ))ei-  second.  AVithin  this 
lange,  each  number,  each  frequency  has  its  own  color.  The  ex- 
ti-eme  visible  red  of  the  rainbow  oi-  spectrum  is  produced  by 
about  892  billion;  the  extreme  \i()let  by  al)out  757  l)i]lion  vibra- 
tions pe)'  second.  Between  these  the  eye  may  rest  U])()n  cei'tain 
distinctix'c  coloi's;  and  the  rr('(|iicii('i('S  coi'i'esijonding  to  tin; 
res])ect i\-e  coloi-s  are: 

lv('<|,  4I)lI-4;  oiangc  reel,  4S4  1  ;  orange,  ^)iy.\-'.\;  orange  yellow, 
')\]-'2;  \clh)\\.  r)17-."');  green,  ."')7<);  bine  green,  .")!)] -4;  cyan  l)lue, 
()()();  blue,  b.').").!';  xioh't  bine,  ()Sr).S;  pure  bine,  740..")  billion  ])er 
second. 


]'iii':.\().Mi';.\A  oi'   i.iciri'  axii  coi.oi;  311 

Li^lit  duo  to  wave  uiotiou  ol'  one  siiiij)l('  j'requoiicy  would 
))('  lioiiio'-'ciicous,  or  iiioiioclii'ouiatic,  light.  If  it  wore  visible,  it 
would  pi'oducc  llic  -iiiiplcst  coloi' sensation.  TIn'  ligld  of  l)uni- 
ing'  sodium  is  a  comiKjuiid  of  two  yellow  lights  ('orresi)oiiding  to 
their  resjjectiYe  wave  frequencies  of  508.9  to  510.6  l)illion  vibra- 
tions per  second;  and  this  is  tlie  nearest  we  have  as  yet  readied 
to  nionochroiiiatic  light. 

The  eye  takes  up  any  congeries  of  monochromatic  light 
impinging  simultaneously  upon  the  same  spot  in  the  I'etina, 
and  the  rcsultiiig  sensation  is  always  that  of  a  single  color,  not 
necessarily  I'esembling  any  of  the  coinponcnts. 

(ifccii    (iihI    riolcl    lif/Jit    hloidcd    In    different   propoytions 
produce  all  the   'nil er mediate  hlues.     Nearly  every  example  of, 
Avhat  Ave  call  colored  light  is  in  real  it  j"  an  admixture  of  several 
monochromatic  lights. 

White  light  is  usually  due  to  a  simultaneous  impact  of  wave 
motions  of  all  visil)le  frequencies;  but  the  sensation  of  whiteness 
may  be  produced  by  the  sinudtaneous  im])act  on  the  retina  of 
two  suitable  spectral  coloi's  such  as  yellow  and  ultra-marine 
blue. 

Colors  vary  in  liue,  in  j/iirili/  and  in  liiniinosity.  The  hue 
determines  the  name. 

The  purity  or  absence  of  admixtui-e  with  white  light  de- 
termines its  richness  (i.  e.,  vermilion  reflects  80  ])er  cent  of  red 
light  mixed  with  20  ^qy  cent  of  white). 

The  luminosity  or  brightness  determines  the  shade  or  tone 
of  color. 

Interference  with  any  of  these  will  cause  a  sensation  of  the 
impression  produced  upon  the  retina  with  a  corresponding  vari- 
ation in  the  color. 

The  color  of  irans])arent  objects  is  due  to  selective  ab- 
sorption. A  red  object  seen  through  greenish  l)lue  glass  aj)- 
l)ears  black;  greenish  blue  glass  absorbs  the  light  from  the  red 
object. 

Hold  the  same  piece  of  glass  up  to  the  sky,  and  the  red 
lights  which  aie  components  of  the  white  light  of  "day"  are 
cut  off;  Avhat  light  ])asses  through  will  ])r()duce  a  sensation  of 
greenish  1)1  uc 

The  color  of  a  trans])ar('ut  body  will   also  a])]iarently  de- 


312  CAST    GOLD    AND    POrvCELAIX    INLAYS 

peiul  111)011  tile  tli*K'kiiest>  ol:'  the  layer  examined;  a  lliiii  layer  of 
iodine  Ya])or  aj^pears  in  dayliglit  to  l)e  ])iirj)le;  a  thicker  layer 
ajDpears  blue. 

Before  a  nonliiiiiinoiis  o])jeet  can  be  seen  otherwise  than  by 
transmitted  light,  it  must  rellect  light;  if  it  does  not  it  will  ap- 
pear black.  Pour  a  colored  liquid  into  a  deep  black  vessel,  it 
will  reflect  no  light  to  the  eye  of  the  observer.  It  absorbs  all 
the  light  and  reflects  none. 

Sprinkle  a  white  i30wder  into  the  vessel  onto  the  surface 
of  the  liquid.  AVhite  light  enters  the  vessel,  it  is  reflected  in 
all  directions  by  the  powder,  but  it  is  in  part  absorbed  by  the 
liquid  and  the  color  of  the  liquid  is  revealed. 

Of  exactly  the  same  kind  is  the  reflection  of  light  by  a  solid 
object.  Bodies  allow  light  to  traverse  them  to  a  very  small 
depth,  and  then  by  internal  reflection  the  light  is  turned  back  in 
all  directions;  absorption  comes  into  play,  the  result  being  that 
the  object  apjoears  to  have  a  definite  color. 

If  the  light  supplied  to  an  object  contains  none  of  the  kinds 
of  light  which  it  can  reflect,  the  object  appears  black,  or  color- 
less; flowers  looked  at  by  the  yellow  light  of  burning  sodium 
will  appear  colorless  or  black  imless  the  flowers  are  yellow; 
surface  reflection  modifying  the  result.  Color  is  not  always  due 
to  selective  absorption.  A  haze  is  blue  if  it  consists  of  fine 
enough  particles;  these  cause  repeated  reflection  and  at  each 
reflection  the  light  becomes  bluer;  because  these  rays  which 
would  have  been  most  refracted  (the  blue  and  the  violet)  are 
most  largely  reflected.  The  color  of  the  sky  is  that  of  a  haze 
i-eflectiug  light  downward.  (Kef.:  A.  H.  Church  on  "Color," 
1887;  and  ''Colour"  by  C.  T.  A¥hitmell,  1888.) 

There  arc  three  primary  colors  and  these  plus  a  modifier 
are  all  the  equipment  the  porcelain  worker  really  needs.  He 
may  for  convenience  use  several  shades  of  the  three  primaries. 

A  primary  coh)]-  is  llia1  w  liidi  can  iiol  be  made  l)y  c()ml)iiiing 
other  colois. 

The  three  ]nimaries  ai'c  ncIIow,  vrd,  and  hluc.  These  may 
be  considered  the  thi'ce  coloi's  of  creation  and  iiicy  ai'e  analogous 
\()  light,  heal,  and  sliadc 

Yelh)W  rej)r('S('nt>  liglil,  life,  and  acti\il>';  and  red  repre- 
seiiis  cohjr  oi'  wai'iiilli,  or  lidincss,  if  yon  j)l('as('. 


riiEXOMENA    OK    LKUIT    AND    COLOR  313 

Blue  represents  shade  or  tone. 

The  modifieis  are  Avliite  and  bhick,  wliich  are  considei'ed  the 
acme  of  liglit  and  shade. 

White  or  Idaek  shoukl  not  l)e  considered  as  colors.  It  seems 
foolish,  and  it  is  foolish  that  assertions  are  made,  first,  that  a 
certain  combination  of  coh)rs  will  produce  white  and  then  that 
the  same  combination  of  colors  will  result  in  ])lack. 

For  some  time  a  color  wheel  was  a  part  of  school  equip- 
ment, designed  to  demonstrate  that  Avhite  was  a  coml)ination  of 
all  colors. 

The  three  primary  colors,  yellow,  red,  and  blue  were  placed 
on  the  disk,  and  it  was  revolved  at  high  speed.  But  the  ini- 
mary  colors  on  the  disk  were  usually  of  a  light  tone,  white  form- 
ing a  great  part  of  them,  and  the  blending  brought  about  by 
rapid  revolution  of  the  disk  resulted  in  a  disk  of  neutral  gray. 

If  we  comliine  yellow,  red,  and  blue,  in  which  uo  white  is 
present,  a  very  dark  shade  will  be  produced,  and  this  will  be 
the  nearest  approach  to  the  absence  of  all  colors,  but  it  will  be 
very  far  from  a  true  black. 

Any  two  primary  colors  mixed  in  equal  parts  form  a  second- 
ary color.     These  are  three  secondary  colors: 


Yellow 
Blue 


I  ^  Red       1  ^  Blue  1  -p.       . 

r"'*"  Yellow  }0™"8''  Eedr^'T'*' 


An  im2)ortant  claim  set  up  by  some  schools  that  the  three 
secondary  colors  are  the  true  j^rimaries,  must  be  here  combated. 

When  a  green  object  is  looked  at  in  a  strong  light  until  the 
eye  is  saturated  with  the  color,  its  complement,  red,  is  j)roduced 
in  the  eye,  and  if  the  eyes  are  closed  the  object  will  appear  a 
bright  red,  instead  of  green,  its  natural  color.  The  same  is 
true  of  the  others.  Purple  will  produce  yellow  in  the  eye,  and 
orange  will  j^roduce  blue.  Plence  the  claim  of  i^rimaries  for  the 
secondaries. 

But  a  more  careful  study  and  observation  will  show  the 
fallacy  of  such  claim. 

The  action  of  complementary  colors  is  always  reciprocal, 
and  the  ]-evei"se  action  of  these  colors  is  much  more  marked. 

Red  will  produce  green  in  the  eye  much  more  (piickly  and 
brilliantly  than  green  will  produce  red. 


ol-t  CAST    C!OLI>    AND    TOltCELAIX    INLAYS 

Yellow  will  produce,  or,  rather,  induce  puri)le,  and  blue 
will  induce  oraii^i2,e  in  the  eye  mucli  more  quickly  than  the 
reverse. 

That  there  is  one  action  of  color  in  light  and  another  in 
l)ignieut  is  not  correct.  The  action  is  the  same  in  both. 
Sanford  proves  this  by  the  following  experiment : 
From  a  piece  of  thin  looking-glass,  cnt  a  couple  of  little 
mirroi-s  one-1'onrtli  of  an  inch  in  width  and  an  inch  in  length; 
stick  jjins  in  lengthwise  throngh  two  small  corks  and  glue  the 
backs  of  the  mirrors  on  to  the  toj^s  of  the  corks  over  the  heads 
of  the  i^ins,  so  they  may  be  stuck  into  paper  and  set  at  any 
desired  angle.  Throw  the  i^rismatic  colors  through  a  iDrisni 
onto  a  sheet  of  white  paper  on  the  wall,  and  i^lace  another  sheet 
of  white  paper  on  the  wall  opposite  the  sheet  uj^on  wdiich  the 
colors  are  shown.  To  prove  that  green  is  a  secondary  color  in 
light,  as  well  as  in  pigment,  produce  it  from  the  adjoining  color 
on  each  side,  blue  and  yellow.  Stick  the  mirrors  one  in  jDure 
blue,  i-eflecting  it  onto  the  white  jjaper  oj^posite;  and  the  other 
in  i)ure  3'ellow,  throwing  them  together  on  the  opposite  paper, 
the  same  green  shown  l)y  the  jirism  will  be  produced.  The 
same  exi)eriment  should  then  be  made  Avith  the  mirrors  in  yellow 
and  red  for  orange,  and  in  l)lue  and  red  for  purjjle.  This  fully 
establishes  the  secondary  character  of  the  three  colors,  for  no 
one  A\ho  has  carefully  studied  this  subject  will  assert  that  a 
coloi'  ])roduced  by  combining  two  other  colors  is  in  any  sense 
a  primary  one. 

Xow  try  the  o))])Osite  ex])erim('id  ol'  i)roducing  the  blue  by 
combining  llic  adjacent  colors  on  each  side  ''the  ])ur])le  and 
tiie  green,''  ami  the  yellow  l)y  combining  green  and  orange,  and 
the  red  by  combining  orange  and  jjui-jjle,  or  any  other  combina- 
tion you  may  wish  to  try.  Note  the  uttei*  I  allure  of  the  experi- 
ments an<l  you  will  he  conNinccd  thai  ra],  blue,  aii<l  yellow  are 
the  ti'ue  and  only  primai'ics  in  light  and  pigments. 

'J'wo  secondary  coloi's,  combined  in  ecpial  j)arts,  ]n'oduce 
a  tertiary  c()lor.  It  ma\'  be  pi'oduced  directly  from  the  ])rimary 
coho's,  by  mixing  all  three  together  in  the  |)i-o|)ort  ion  of  two 
])arts  ()['  one;  to  one  part  each  of  the  otiiei-  two;  tci-t iai'ies  ai'i; 
citrine,  russet,  and  olixc 


PRIMARIES 

Yellow 
Yellow 


Blue 
Blue 

Red 


Yellow 


I'll  i';.\().M  i';.\.\   oi'   i.icirr  and  coloi; 

TERTIARY  SEC0NDAI;Y 

Or;uijic 

Citrine 

"Green 


.)1.) 


Russet 


■Orarifro 


-Purple 


Purple 


Green 


-Yellow 
-Red 


This  is  as  far  as  tlie  analysis  of  color  can  iiroceed,  hocauso 
it'  two  tertiaries  were  to  he  joined  for  a  (juaternary,  it  would  l)e 
the  comhininii,'  of  the  three  piiniaries  in  almost  equal  i:>ropor- 
tion,  and  so  we  would  get  an  a|)])i'o\i]iiat('  ahsenee  of  color. 

Only  two  primary  colors  are  comhined  simultaneously  in 
the  l^rism  or  rainhow;  for  this  reason  no  tertiary  coloi"S  are 
present  in  prismatic  or  i-ainl)ow  colors. 

An  intermediate  color  is  a  color  ])etween  a  primary  color 
and  a  secondary  color,  and  is  made  hy  ccmihining  a  i^rimary  and 
a  secondary  in  equal  i)arts;  or  it  may  he  made  directly  from  the 
l)rimary  colors  l)y  mixing  two  primaries  in  the  proj)ortion  of 
three  parts  of  one  to  one  ])art  of  the  oilier.  There  are  six  inter- 
mediate colors:  sulphur  (yellow-green) ;  saffron  (yellow-orange) ; 
nasturtium  (red-orange) ;  garnet  (re(h])urple) ;  campanula  (hlue- 
purple) ;  and  turciuoise  (hlue-green). 

These  six  intermediate  coloi-s  ai'e  usually  divi(k'd  into  a 
grade  of  five  shades  raiigliig  IVoiii  Ww  j)i-iiiiai'y  to  the  secondary 
hetween  which  eacii  coh)]'  slaiids,  and  Ihis  gra(hiati()ii,  together 
witli  the  niultitu(h'  of  shaih's  of  primaries  and  secoudai'ies,  pro- 
vides an  endless  varietv  of  color. 


116 


CAST    GOLD    AXD    PORCELAIX    INLAYS 


Fig.   305. 

A.  YoUow,  jiiimaiy. 
JJ.  Ked,  piiuiiiiy. 

C.  Blue,  x^i'i"i^''.y- 

D.  Purple,  secondary  :^  one  i)art  B  +  one  part  C. 

E.  Orange,  .secondary  =;  one  part  B  +  one  part  A. 

F.  Green,  .secondary  :=  one  part  C  +  one  j^art  A. 

G.  Olive,  tertiary  :•=  one  part  Z>  +  one  part  F. 
H.  Russet,  tertiary  =  one  part  D  +  one  ])art  E. 
I.    Citrine,  tertiary  =  one  part  E  +  one  part  F. 

J.    .Sulphur,  intermediate.     '.'A. +  iB +  1C',  or  lA  +  IF. 
K.  Turquoise,    intermediate.      'AC  +  IA,    or    IF +1(7. 
L.  Campanula,   intermediate.      '.iC\-lB,   or  D  +  C. 
M.  Garnet  or  red   puij)le,  intermediate.     3B  +  1C. 
N.  Nasturtium,  intermediate.     ?>B  +  1A,  or  IB +  17?. 
0.  Saffron,  intermediate.     ?,A  +  iB,  or  1.1,  + IF. 


IMIIOXO.MKXA    Ol"    IJCIIT    AND    COl-Oi;  IWI 

Complete  Chart  of  the  Prismatic,  or  Rainbow,  Colors 

It  will  he  noted  that  both  in  tlie  color  f^'uide  and  in  tlio 
])rismati('  cliaii,  indigo  d()(\<  not  api)ear,  altlionfth  it  was  in- 
cluded by  all  eolorists  froiii  Xewton's  time  u])  to  1890,  when 
the  discovery  was  made  that,  bein<;'  a  comhiuation  of  black  and 
blue,  indig'o  never  had  Ijeen  ])resent  and  should  not  be  included 
in  the  prismatic  colors. 

As  will  be  readily  seen,  all  colors  come  from  tlie  three 
])rimary  colors,  red,  yellow  and  blue.  The  secondary  and  inter- 
mediate colors  are  formed  in  the  prism  or  rainbow  by  a  blend- 
ing of  the  primary  colors;  the  red  and  yellow  blendinft-  together 
and  forming  all  grades  of  orange,  from  red-orange  to  yellow- 
orange;  and  the  yellow  and  blue  blending  together  into  all 
shades  of  green,  from  yellow-green  to  blue-green.  Purple  is 
formed  both  at  the  top  and  bottom  of  the  rainbow,  by  reflection 
of  the  red  and  blue,  which  are  refracted  out  of  a  direct  line,  and 
consequently  reflected  on  the  inner  surface  of  the  prism  or  rain- 
bow as  shown  in  the  chart,  the  red  being  reflected  from  the  bot- 
tom into  the  blue  at  the  top,  thus  forming  purple.  Violet  is 
purple  in  a  diluted  form,  and  as  it  is  a  reflected  color  in  the  rain- 
bow, and  consequently  weak,  may  reasonably  be  called  violet, 
but  is  in  reality  purple. 

The  blue  is  also  reflected  into  the  red,  and  j^roduces  pur- 
l)le  at  the  bottom.  Colorists,  not  having  looked  for  this,  have 
failed  to  observe  it,  but  it  may  be  plainly  seen  in  any  bright 
rainbow. 

The  red  reflecting  into  the  blue  at  the  top  produces  all 
grades  of  purple  between  pure  purple  and  red-purple.  It  will 
thus  be  seen  that  all  colors  appear  in  the  prismatic  or  rainbow 
colors,  excepting  the  tertiary  colors — citrine,  russet,  and  olive 
— which,  being  a  simultaneous  combination  of  all  three  primary 
colors,  cannot  themselves  exist  in  the  prismatic  colors. 

Harmony  of  Colors 

The  way  color  affects  the  eye  is  not  only  very  interesting, 
but  is  very  important  to  every  person  who  has  eyes.  "When 
the  eye  looks  at  a  coloi-,  not  the  color  itself  but  its  opposite, 
called  its  complementary  coloi-,  is  absorbed  by  the  eye,  and  if 


318  CAST    COLD    AND    I'OltCKI.AI  X     IXLAV^^ 

tlio  eyes  are  cIoscmI,  tlic  oljjcct  ^\ill  he  seen,  not  in  tlio  color 
tlio  CYC  saw  wlicn  open,  Init  in  its  coiiiploiiieiitary  color.  If  a 
I'od  color  is  looked  at  until  tlie  eye  is  satnrated  witli  the  color, 
and  tlie  eyes  are  closed,  llie  oljject  will  he  seen,  not  in  red,  bnt 
in  a  hriglit  groiMi.  It'  the  eye  sees  a  l)ri,<;-lit  yellow  until  it  is 
tilled  with  the  color,  it  will  he  seen  witli  closed  eyes  in  a  rich 
13urple.  Therefore  when  one  color  is  seen  it  is  important  that 
the  next  color  looked  at  shall  harmonize  with  the  color  Nature 
has  formed  in  the  eye,  or  an  unpleasant  shock  will  he  expe- 
rienced ctnd  the  pleasing  sensation  of  harmony  destroyed  just 
as  effectually  as  a  clash  of  sounds  shock  the  ear. 

This  creation  of  the  complementary  color  is  not  confined 
to  the  eye  alone,  Init  all  Xature  capable  of  reflecting  color 
shows  the  same  action;  for  example,  a  yelloAv  sunset  reflects 
purj^le  in  all  cloud  and  snow  shadows. 

The  matter  of  comj^lementary  color  is  a  simple  one,  not  dif- 
ficult to  understand,  and  everyone  should  learn  it. 

To  each  color  there  is  one  other  color  which  is  comj)le- 
mentary.  A  complementar}'  color  is  one  which  supj^lies  what  is 
lacking  in  the  other;  for  example,  green,  which  contains  yel- 
low and  blue,  lacks  red,  therefore,  red  supplies  what  is  lack- 
ing in  green  and  is  its  complement,  and,  vice  versa,  green  is 
the  com23lement  of  red. 

In  every  case  complementary  colors  are  reciprocally  com- 
plements of  eacli  other.  In  the  color  guide,  the  complementary 
colors  are  shown  o])])osite  each  other.  Eed  and  green  are  com- 
])lements,  as  are  yellow  and  jmi-ple,  as  well  as  blue  and  orange. 
It  becomes  a  sim])le  matter  of  remembering  tliese  three  sets  of 
complements  and  Icni-ning  to  balance  shade  for  shade,  and  tint 
for  tint. 

The  more  delicate  these  halaiices,  the  Mioi-e  sul)tle  and  ex- 
quisite may  he  the  effect  of  coloi'  hai'nion\'  ui)on  the  eye. 

Rule  1. — ('onii)l"nien1ary  colors,  when  ])laced  side  by  side, 
brighten  each  olliei-. 

It  is  impoi'tant  1o  nndei'stand  well  llie  following  simi)le, 
na1ui-al  ininciples.  As  has  been  stated,  each  color  produces 
its  coniplcnienl  in  tlie  eye.  If  one  look's  at  I'ed,  green  is  created 
in  the  eye.  This  is  not  a  delusion  hut  a  ])ractical  fact.  If  one 
lias  seen    led,  and   there   is  conse(iuently  green   in   th(^  eye,   if 


I'll  i:.\().M  l';.\A    Ol'    IJCIIT    AND    COLol;  319 

llic  ('\('  liini  from  red  to  ii'i-ccii,  thai  is,  if  llic  ,i;;r/('  \)v  ({iiickly 
sliit'lcd  I'loiii  a  i-('(l  lo  a  ni'ccii  siii-racc,  ilic  .ni'ccii  wliicli  lias  l)een 
])i'()(lii('('(l  ill  llic  eye  Ity  llic  I'cd,  will  add  lo  Ihc  ^rccii  wo  ai"o 
looking'  at  and  il  will  aitpcar  iiioro  brilliaiii  than  il  would  have 
a])poai'('(l  if  llic  cNc  had  iiol  jiisl  been  lookiii;;'  at  red.  HMiis  ox- 
])laiiis  the  piinciplc  of  llic  lirsl  rule  in  the  hai'uiouy  of  coloi'. 
It  will  thus  he  understood  that  if  hrilliaucy  of  color  is  desired 
it  must  be  attained  by  the  apjjjicatioii  of  lliis  ])iinei])Ie.  Two 
('ouii)leiiientary  colors  must  in  souie  way  be  so  ai-i'an<;ed  as  to 
a])])ear  in  juxtaposition. 

liulc  v. — C^oinplcincnlary  colors,  ^vhen  mixed  to^'clhcr,  kill 
each  olhei'. 

We  must  now  conic  to  the  mailer  of  subduin<;-  instead  of 
lici^^htening  color,  which  may  easily  ])e  done  by  ol)servinf;-  an- 
other action  of  Nature.  The  same  color  which,  if  placed  be- 
side a  color,  will  bri<;hten  it,  if  mixed,  will  lill  it.  If  red  be  too 
red,  f^reen  is  the  only  color  that  will  take  the  redness  out,  or 
subdue  it;  and,  vice  versa,  if  green  be  too  green,  red  is  the  only 
color  that  can  subdue  the  greenness. 

This  fact  is  of  equal  force  with  every  other  color;  rod  and 
green  are  complements  and  will  not  only  brighten  each  other  in 
juxtaposition,  l)nt  will  negate  each  other  when  mixed  together. 
The  same  is  true  of  yello^\'  and  jDurijle  and  of  blue  and  orange. 

By  observing  these  rules,  an}^  desired  effect  in  the  harmony 
of  color  may  be  produced;  a  color  may  be  heightened  by  the 
simple  method  of  placing  its  complement  next  to  it;  or  sub- 
dued (if  less  brilliancy  is  desired)  by  mixing  its  complement 
with  it.  The  symphony  of  practically  one  color  produces  the 
comjjlement  in  the  eye,  and  if  this  created  comi^lement  is  not 
neutralized  by  the  actual  presence  of  the  same  color,  it  blends 
in  the  eye  with  the  local  color  and  subdues  it. 

The  range  of  comjilementary  colors  is  not  wide  and  com- 
plex, but  very  simi)le  and  contined  strictly  to  the  three  j^ri- 
maries,  the  three  secondaries  and  the  intermediate  colors. 

If  a  color  be  a  primary,  a  secondary  is  its  complement.  If 
a  color  be  a  secondary,  a  primary  is  its  complement. 

If  a  primary  color  has  but  a  small  amount  of  another  iiv'i- 
mary  in  it,  thus  turning  the  predominating  color  a  little  away 
from   the   ])i-iniary,   its  com]ilement  will   contain  just   as    much 


CAST    C;OLD    AND    POKCELATX    INLAYS 


INTEnMKDIATE  COLORS 


Yellow 

Yellow 
Yellow 


Yellow 
Yellow 


Caiiipamila- 


^Blue 
(Secondary)      (Primary) 
-Purple   -   Blue-Ecd 


Turquoise 


Blue 


(Secondary)   Yellow  and 
reen  -         \   Blue 


Sulphur  or  Yellow^Greon 

(Secondary) 

reen  -  Yellow  and  Blue 


Saffron 


(Secondary) 
•Orange      Yellow  and  Rod 


Nasturtium 


anict 


(Secondary) 

Orange  -  Yellow  and  Tied 


-Red 


(Secondary) 
—  Purple-  Red  and  Blue 


'IIKNOM  K\.\    OK    IJCIIT    .\.\l)    COLoi; 


821 


more  ol'  tlic  iciiiainiii,!;'  lliinl  pninaix .  Fov  example:  IT  red  has 
a  little  yell()\\-  in  it,  tiii'iiiiii;-  il  lowai'd  nasi iii1  iuiii,  or  i-od-oraiift'o, 
its  coiiipleiiieilt  L;i-eell,  lilllst  liaxc  just  lliat  llllicll  more  Mile  ill 
its  ('oiii])ositioii,  turning'  it  toward  tur({iioi.se,  oi-  l)liie-<;reeii.  In 
tliis  way  tlie  six  iiiterni<  diary  coloi-s  may  he  compleiiieiits. 

A  fact  to  he  reiiiemhered  in  the  harmony  of  colors  is  that 
white  oi-  hhu'k'  added  to  any  one  of  the  piimaries,  ])r()du('es  two 
colors  of  (piite  opposite  (  ffect,  that  always  harmonize  with  each 
other,  as  they  are  virtually  li,i;lit  and  dark  of  the  same  color. 

White  a,d(le(l  to  yellow  will  pioduce  straw,  or  cream,  color, 
according-  to  the  yellow  used;  and  hlack  added  to  yellow  pro- 
duces olive,  therefore,  straw,  or  cream,  and  olive  produce  ])ink; 
hlack  added  to  red  produces  maroon;  hence  jjink  and  maroon 
will  alwa\s  harnionize, 

AVhite  added  to  Idue  produces  azure;  hlack  added  to  hlue 
])ro(luces  indig'o;  hence  azure  and  indigo  will  always  harmonize. 


CHAPTER  XXI 
THE  PORCELAIN  INLAY 

If  we  now  lalve  up  tlie  consideration  of  the  porcelain  inlay 
as  a  distant  oj^eratiou  by  itself  and  not  in  combination  witli 
gold,  we  shall  iind  ourselves  compelled  to  designate  the  indica- 
tion and  contraindication  for  the  i^erformance  of  this  operation, 
and  we  find  tliat  the  best  general  rule  that  may  be  laid  down 
would  resolve  itself  into  dogmatically  stating  that  porcelain 
must  be  used  where  gold  would  be  objectionable  because  of 
esthetic  reasons.  In  other  words,  all  the  surfaces  of  decayed 
teeth  which  would  upon  being  restored  be  exposed  to  view,  must 
be  filled  with  a  material  which  will  not  be  objectionable  to  the 
eye,  providing  the  conservation  of  the  teeth  would  l)e  brought 
about  to  a  satisfactory  degree.  On  the  other  hand,  another  prin- 
ciple that  might  be  almost  general  in  its  aiDplication  is  in  my 
opinion,  well  stated  in  this  following  sentence:  No  occlusal  sur- 
face of  any  tooth  which  would  upon  restoration  be  opposed  by 
a  natural  dental  organ,  should  be  restored  by  porcelain,  when 
other  materials  may  be  had  for  that  purpose. 

I  realize  that  I  lay  myself  open  to  severe  criticism  on  the 
part  of  those  who  blindly  and  fanatically  follow  the  porcelain 
call,  ))ut  I  would  call  the  attention  of  the  ])ractitioner  and  the 
student  to  the  fact  that  ])r()i)eily  fused,  ])()rcelain  is  infinitely 
harder  in  texture  and  resistance  than  the  natural  tooth  enamel, 
and  so  under  the  stress  of  nuistication  the  latter  will  suffer  by 
attrition,  and  the  damage  created  will  far  outweigh  the  tem- 
])Oi'ai\v  estlictic  satisFacliou  obtained  by  the  operator  in  com- 
l)leting  his  operation  in  Hie  inateiial  mentioned. 

It  is  fai-  better  to  icstore  the  occlusal  surface  of  natural 
teeth  which  lia\-e  deca_\(M|  in  a  material  that  is  somewhat  softei' 
or  more  yielding  than  the  natni-al  tooth  enamel,  and  thus  run 
tlie  risk'  of  having  to  peilorm  tiie  operation  again  rather  than 
endangei-  the  integrity  of  teeth  that  are  in  no  way  involved 
hy  d<*cay.    It  would  seem  too  that  j)orcelain  is  a  material  jiecu- 

322 


TIIK    I'OIK'KLAIX     IXI,AY  oJ.) 

liarly  n(lai)t('(l  to  r('j)laeiti^'  liiosc  jiails  of  natural  tcctli  tliat 
arc  ill  {'lose  |)r().\imity  to  the  ^iini  tissue,  and  tlie  reason  for 
tliat  may  he  round  in  the  fact  that  poi'celain  is  vei'y  dense,  and 
may  he  fused  to  a  \-er\-  lii,i;li  polish,  so  that  U|)oii  eeineiitat ion 
into  i)hu'e,  it  will  ])rescnt  no  I'ougli  surfaces  for  any  feniient 
products  to  attach  themselves  to  and  so  inva<le  the  viiliieral)le 
gum  tissue  area. 

l>yraiii,  in  an  elahorate  nioiiograi)li  on  the  suhject  of  por- 
celain iiday  work,  practically  concedes  to  porcelain  the  realm 
of  the  entire  inoutli,  preferring  it  to  any  other  filling  material, 
but  I  think  that  he  was  mistaken  in  his  deductions  and  in  liis 
conclusions,  for  the  reason  stated  above. 

The  dental  porcelains  as  we  use  them  are  composed  of' 
silex,  kaolin,  and  feldsjjar,  iluxes  and  pigments,  or  coloring- 
matter. 

Silex  is  an  oxide  of  silicon,  an  infusil)le  substance  insol- 
uble in  all  acids  except  hydrofluoric,  slightly  solul)le  in  caustic 
alkalies,  and  forms  about  14  per  cent  of  the  ])asal  mass  of 
porcelain.  It  adds  to  its  strength  and  gives  it  a  translucent 
appearance. 

Kaolin  or  silicon  of  aluminum,  consists  of  an  aluminum  ox- 
ide, silicon  oxide  and  water,  sometimes  spoken  of  as  disinte- 
grated feldspar.  Through  natural  decomposition  feldspar  loses 
its  potassium  oxide  by  the  action  of  w^ater  and  other  agents. 
Kaolin  forms  about  4.5  per  cent  of  the  porcelain.  It  is  a  highly 
refractory  clay  when  heated  alone,  but  readily  unites  with 
feldspar  when  mixed  with  it.  It  supplies  the  porcelain  with 
stability  of  form,  which  permits  it  to  he  molded  and  carved  be- 
fore being  fused. 

Feldsjiar  is  a  duplicate  silicate  of  aluminum  and  potassium. 
In  other  words,  it  is  comj^osed  of  aluminum  oxide,  j^otassium 
oxide,  and  silicon  oxide,  so  that  it  would  seem  that  the  differ- 
ence between  feldspar  and  kaolin  is  the  possession  by  the  for- 
mer of  potassium  oxide,  and  the  possession  of  kaolin  of  the 
water  of  crystallization.  Feldspar  composes  al)out  82  per  cent 
of  the  basal  mass  of  porcelain,  a  highly  refractory  material, 
almost  infusilile  in  ordinary  electric  furnaces. 

In  order  to  increase  the  fusibility  of  this  basal  j^orcelain 
and  make  it  possible  for  the  general  i)ractitioner  to  use  it  in  his 


324  CAST    COLD    AXl)    POlH'Kl.AIX    IXLAYS 

jiractirc,  llii.ves  are  added;  siu-li  suhstaiiccs  as  sodium  l)orale 
(Xa340:):  sodiiiiii  carbonate  (Xa,('(),);  potassiiiin  carbonate 
(K.CO,,),  or  <;'lass  wliicli  contains  oxides  of  potassium  or  sodium 
forming  tlie  greater  j^art.  All  these  tiuxes  are  ground  together 
with  the  ])oreehiin;  then  upon  fusing  a  cheniieal  change  takes 
])lace  forming  an  indefinite  compound,  from  wliich  none  of  the 
original  ingredients  can  be  removed  except  by  some  jn'ocess 
Avliich  involves  tlie  destruction  of  other  ingredients. 

The  i)igments  or  coloring  matters  most  commonly  used  in 
the  manufacture  of  dental  i)orcelain  are  i^recipitated  gold,  jjlat- 
inum,  purple  of  Cassius  (the  oxide  of  gold  and  tin),  the  oxides 
of  gold,  titanium,  manganese,  and  silver.  The  colors  produced 
by  the  use  of  these  pigments  in  varying  proiDortions  are  hues 
of  red,  yellow,  l)lue,  green,  l)i-own  and  gray. 

Dental  jiorcelain  may  l)e  divided  into  high-  and  low-fusing 
jjorcelain.  High-fusing  i)orcelain  is  one  that  will  fuse  above 
tlie  melting  point  of  pure  gold,  and  low-fusing  porcelain  some- 
where below  that  point. 

Byram  states  that  any  enamel  bod}^  can  be  fused  on  pure 
gold  i3roviding  enough  time  is  given.  Some  low-fusing  porce- 
lain will  fuse  above  the  fusing  point  of  pure  gold,  provided 
the  requisite  heat  to  fuse  pure  gold  is  obtained  rapidly. 

He  also  adds  that  while  the  above  distinction  seems  to  meet 
all  practical  requirements,  it  is  unscientilic  and  its  only  value 
is  to  make  a  convenient  distinction  between  the  two  classes  of 
porcelain  for  ])ractical  usage. 

He  also  makes  the  following  distinction  between  high-  and 
low-fusing  porcelain:  High-fusing  porcelains  require  more  than 
five  minutes  to  fuse,  while  low-fusing  jwrcelains  require  less 
1lian  (ive  minuies  to  I'use  at  2,000°  F.  ft  is  impossible  to  fuse 
aii>-  of  tlie  liigli-rusing  ])orcelains  at  2,000'  F.  in  five  minutes, 
and  it  is  also  im])()ssible  to  keej)  any  of  the  low-fusing  ])orce- 
lains  in  contact  with  a  heat  of  2,000  l'\  loi-  fnc  minutes  with- 
out  becoming  oveiTused. 

He  divides  j)orcehrui  bodies  into  l)asal,  or  foundation,  bod- 
ies, emimel  bodies,  and  glazes.  All  hasal  and  I'oundation  bod- 
ies he  says  are  high-l'using  poi-celaiiis,  w  hile  enamel  bodies  and 
glazes  ai'c  <'i1h('r  lii.Lili-  or  low-fusing  porcelains. 

'I'lie  lia>al  hodies  ai'(^  used  in  crown  and  hridge  work  For  the 


TIIK    TOItCKI.AI  X     I.XLAV  '^'27) 

coiistriicl  ion  of  liaiid-r.-ii'NiMl  Icclli.  and  llicx'  i'('<|iiii'('  a  spcciallN' 
coiistniclcd  I'liniacc  in  oi-dcr  lo  niainlaiii  flic  iidcnsc  heat 
iRMdcd  to  fuse  llicin.  TIk'  I'oundalion  and  enamel  hodies  nii,i;ld 
meet  tile  i'e(|ni I'emeids  I'oi'  iiday  woi'k  and  it  is  best  I'oi"  the 
o])erat()r  who  intends  to  pert'ecl  liimselt'  in  this  work,  to  limit 
liis  ex])eriments  to  tli(  so  lattor  ])0(lies.  Tliese  ))oi('(dains  used 
i'oi-  inlay  woi'k  may  he  mixed  \vitli  alcohol  or  tliey  may  ])e 
mixed  w  itii  watei'.  The  lattei-  ])ro('ess  ,i;ives  a  hody  more  easily 
cai'ved  t  lian  the  fonnt  i'. 

From  an  elaborate  sei'ies  of  ex])eriineids  l)yi'am  de(lncted 
the  follow ini;-: 

1.  Porcelain  has  no  definite  fusing'  point. 

2.  By  ])r()loni;-ino-  the  time  of  exposing  to  heat,  a  thoroughly 
fused  ];oi'('elain  may  he  ol)tained  at  a  comparatively  low  teni- 
jjerature.  I  do  not  agree  Avith  Byram  in  this  respect;  at  least 
1  contend  that  the  reasoning  of  Byram  in  this  instance  was  in- 
correct, and  that  the  amount  of  heat  present  in  the  electric  fur- 
nace nnifile  at  the  time  of  the  fusing  of  that  porcehiin  was 
greater  than  was  indicated  upon  the  i^yrometer  or  other  instru- 
ment used  by  Byram  in  determining  his  degree  of  heat.  The 
effect  of  heat  u})on  the  porcelain  is  cumulative,  and  the  vibra- 
tions of  the  heat  waves  in  themselves  tend  to  create  heat  plus, 
and  thus  even  though  the  degree  indicated  upon  his  instrument 
was  lower  than  he  thought  would  be  required  to  fuse  that  por- 
celain, he  must  have  of  necessity  been  in  possession  within  his 
muffle  of  the  requisite^  amount  of  heat  to  fuse  the  mass.  So  I 
would  rather  have  it  understood  by  tlie  student  that  the  sec- 
ond deduction  of  Byram  is  not  an  axiomatic  truth. 

o.  "Porcelains  fused  at  a  lowxn-  temperature  and  for  a 
longer  time  will  maintain  their  characteristic  color,  and  will  1)e 
more  homogeneous  in  texture,'*  which  I  would  rather  have  read 
as  follows:  "The  more  carefully  porcelains  are  fused  and  the 
more  slowly  the  heat  is  allowed  to  permeate  them  until  they 
reach  the  fusing  ])oint,  the  more  homogeneous  will  they  be  in 
texture,  and  the  more  certain  they  will  be  in  color." 

4.  Low-fusing  jiorcelains  can  be  made  of  high-fusing  porce- 
lain by  repeated  fusing  and  grinding;  which,  while  perhaps  true, 
seems  to  be  an  anomaly  wIkmi  we  consider  the  fact  that  each 
fusing  and  grinding  disi)oses   of  ])art   of  the   flux,   and   so  we 


32(i  CAST    COLD    AXD    r(~)rvCELATX    INLAYS 

liave  ultimately  tlic  basal  ])odies  or  the  oiuiinel  bodies  to  deal 
Avitli,  botli  of  wliieli  are  lii,i;lily  retVaetory  eoiiipounds  not  read- 
ily subject  to  fusing. 

5.  If  a  piece  of  porcelain  is  tlioronglily  fused  and  more 
13orcelain  is  added  and  fused,  tlie  first  layer  will  be  slightly  over- 
fused.  In  the  process  of  applying  porcelain  in  layers  and  fus- 
ing each  layer,  the  underlying  layers  will  l)e  slightly  overfused 
and  somewliat  lighter  in  color,  which  should  carry  the  warning 
to  the  student  that  porcelain  restorations  should  be  biscuited 
until  the  required  amount  of  bulk,  outline,  and  contour  has  been 
obtained,  and  that  the  jjorcelain  restoration  must  be  fused  only 
once. 

6.  A  small  mass  of  porcelain  is  more  readily  affected  by 
heat  than  a  larger  one,  and  as  the  size  of  the  mass  of  porcelain 
increases,  just  in  that  ratio  does  the  length  of  time  necessary  to 
fuse  it  increase. 

7.  Porcelains  containing  a  large  percentage  of  flux  are  more 
easily  affected  by  bubbles  than  tliose  that  are  more  nearly  com- 
posed of  the  basal  ingredients.  Very  readily  comprehended 
when  we  realize  that  the  tendency  of  all  fluxes  is  to  leave  the 
porcelain  in  the  form  of  gases  and  that  these  gases  forcing  them- 
selves into  and  between  the  molecular  spaces  of  the  porcelain, 
prevent  homogenous  arrangement  of  the  molecules, 

8.  It  is  more  difficult  to  maintain  the  characteristic  color 
of  low-fusing  than  high-fusing  porcelains  when  held  for  a  long- 
time at  the  maxinmm  heat  required  to  fuse  theuL 

9.  Low-fusing  porcelains  are  denser,  have  greater  sliriidv- 
age,  and  less  Iciisih^  strength  than  high-fusing  porcelains. 

10.  By  rejjeated  heating  of  ])orcelain  to  the  point  of  high 
bixMiiliiig,  it  will  finally  become  fused  and  maintain  its  charac- 
l('ri>!ic  coloi". 

11.  lligh-rusiiig  poi'cclaiiis  shi-ink  from  15  to  25  per  cent, 
whih'  low -fusing  poi-celains  shi-ink  from  20  to  o5  per  cent. 

There  is  an  ei'i'oi-  in  the  ninth  and  eleventh  deductions 
which,  because  of  tlicii'  unimportance  to  the  student,  will  not 
be   1;ik('n    up. 

1l!.  a  coarsely  gi'ound  ])orcelain  fuses  at  a  higher  tem- 
jjeiatnrc  ;iiid  shiink's  h'ss  than  one  of  the  same  fornuila  finely 
ground. 


TIIK    I'dltCKLAIiV    INLAV  .  327 

K).  The  aiiiouiit  ol'  sliriiika<;('  of  any  porcelain  will  in  a 
measure  l)e  dependent  upon  the  consisteucy  to  wliicli  it  is  mixcMl 
and  the  density  to  whicli  it  is  condensed;  the  thin  niixtui'e 
sliowino-  more  shrinkage  tluin  tliat  of  tlie  ])utty-like  consisteney. 

14.  Underfused  jjorcelain  is  more  o))a(pie.  Overfused  por- 
celain becomes  lig-liter  and  tends  to  heconie  more  trausparent. 
Overfused  porcelain  loses  in  streu'^tli  in  ))i()p<»ition  as  tlie  tem- 
l)erature  is  increased. 

15.  The  tendency  of  l)otli  lii^li-  and  io\v-rusin<;'  ])orcelain  is 
to  assume  s]>her()i(lal  foiin  when  overfusiMl,  and  if  considerably 
overfused  they  tend  to  form  an  ainor])lious  mass  of  fi,lass. 

Byram  quotes  tlie  follo^\■in,^•  advantages  for  ])()rcelain  as  a 
filliuf^'  material : 

1.  Fillin«''s  can  be  inserted  much  more  nearly  liarmonious 
witli  the  natural  teeth. 

'2.  Porcelain  is  a  poor  conductor  of  thermal  chan,i;-es  and 
a  nonconductor  of  electricity. 

3.  The  mai-i^'ins  of  cavities  j)ioprrli/  (  t)  tilled  ^vith  p)or- 
celain  are  not  readily  attacked  by  caries. 

4,  The  cement  used  as  a  retainin<:,-  medium  ^ivinf;-  the  fill- 
ing the  greatest  adhesion  of  all  of  the  filling  nuiterials  excex)t 
cement. 

T).  The  jjatient  is  relieved  of  sitting  with  a  rubber  dam 
adjusted  over  the  mouth  for  periods  of  considerable  length  and 
of  the  pain  incident  to  adjusting  the  rubber  dam  and  cervical 
clamps  for  cavities  extending  beneath  the  gum. 

6.  The  nervous  strain  on  both  the  patient  and  the  dentist 
is  lessened,  thereby  relieving  the  patient  of  the  shock  whicli 
usually  follows  long  and  tedious  oi^erations. 

7.  If  a  porcelain  tilling  is  faulty,  it  is  easily  displaced,  and 
the  patient  knows  immediately  that  the  sei'vices  of  a  dentist 
are  required. 

Among  the  disadvaidages  of  jiorcelain  as  a  tilling  material, 
he  states: 

1.  The  friability  of  ))orcelain  causes  it  to  fracture  I'eadily, 
thereby  excluding  it  from  any  form  of  cavity  that  cannot  be 
so  prepared  that  the  overlying  margins  of  the  tilling  material 
can  be  formed  or  else  protected  from  strain. 

2.  It  is  impossible  to  bevel  the  cavity  sometimes  to  protect 


328  CAST    GOLD    AXD    PORCELAIX    IXLAYS 

tlio  cMiamel.  Tlie  relative  stren,<;lli  of  llie  ])()reelaiii  and  enamel 
are  appri^xiiiiately  the  sain(\  so  that  one  cannot  protect  the 
other. 

o.  It  is  difheiilt  to  match  tlie  c()h)i-  of  the  natural  teeth. 
This  ahvays  has  been  and  always  will  he  the  most  serious  dis- 
advantage of  porcelain  as  a  hllin<.v  material  and  until  we  under- 
stand more  thoroughly  the  general  phenomena  of  color  forma- 
tion, we  may  exj^ect  to  l)e  disaj^pointed  with  many  of  our  in- 
lays. 

4.  The  cement  used  as  a  retaining  material  may  cause  a 
change  in  the  color  of  the  tooth  or  of  the  inlay.  This,  however, 
may  he  largely  overcome  by  the  aj>i3lication  of  correct  prin- 
ciples in  cavity  preparation. 

.").  The  cement  will  dissolve  unless  there  is  only  a  thin  film 
used  as  a  retaining  medium.  This  is  not  so  much  a  disadvan- 
tage to  the  skillful  operator,  for  if  the  margins  are  defective  he 
will  remove  the  defect  hy  making  a  new  inlay;  but  to  the  in- 
competent or  careless  operator  this  will  always  be  a  disadvan- 
tage because  any  cement  now  produced  will  dissolve  from  the 
margins  of  an  ill-titting  inlay. 

As  to  the  applicability  of  jjorcelain  as  a  filling  material,  it 
will,  in  my  ojiinion,  i:>rove  confusing  to  quote  Byram  on  this 
subject,  and  it  will  be  best  for  the  student  to  bear  in  mind  that 
the  writer  considers  porcelain  a]jplicable  in  simple  cavities  only, 
excej)t  in  the  six  antei'ior  teeth  where  compound  cavities,  that, 
is,  cavities  involving  more  than  one  surface  of  a  tooth,  may  be 
filled  Avitli  this  material.  No  compound  cavities  in  1)icuspiils  or 
molars  should  be  filled  with  porcelain. 

CAVITY  PREPARATION 

The  prcparalioii  of  simple  ca\'ilies  foi'  the  rece])ti()n  of 
porcelain  inlaxs  lias  already  heen  onllined  in  lliis  woi-k.  It  will, 
liowever,  lie  Ix  si  lo  reitei-ate  llial  llie  walls  of  tliese  simple 
cavities  iiiii>1  (|i\-ei-ge  so  that  the  lloor  of  the  eaxity  shall  form 
\\\\\\  the  walls  of  the  ('a\'ily  an  angle  of  at  least  one  hundred 
degre(  s.  This  will  insure  a  more  iierl'eet  seating  ot*  the  inlay 
in  the  cavity  than  could  he  ohl.-iined  if  the  walls  and  (loor  of  the 
eaxity  forjne(l  a  right  angle.     It   must   he  readily  ai)parent  that 


TIIK    I'OItC'KLAIX    1XI>AV  '.l'2[) 

a  j)latimiiii  or  a  ,i;()l(l  mat  fix  occupies  some  space,  and  since  the 
])()i-celaiii  must  be  halted  in  a  mati'ix  aiul  that  mati"ix  subse- 
(|ueiitly  sli-ipj)e(l  olT  the  i)()rcehiin  iiihiy,  some  space  will  be 
])i-es(  nt  between  the  ca\ity  and  the  inlay,  which  space  is  su])se- 
((ueidly  Idled  by  cemeid.  if  then  the  walls  and  floor  of  the 
cavity  are  at  a  i-i.nlit  au,i;le  to  each  otliei',  tliei'e  will  be  a  cement 
line  showinn-  all  around  the  inlay.  IT,  howevei",  tlie  flooi*  and 
walls  of  the  ca\ity  ai-e  at  an  obtuse  an,'j,le  to  eacli  other,  upon 
the  removal  of  the  ])latinum,  the  inlay  will  be  allowed  to  seat 
itself  fui'ther  iido  tlie  cavity  and  because  of  its  wed^-'e  forma- 
tion (of  obtuse  an,i;le  foi'mat ion )  will  nioi'e  closely  seal  tlie  cav- 
ity at  its  external  or  iuar,i;iiial  surface.  This  will  sometimes 
entii'ely  ()))literate  any  evidence  of  cement  except  that  the  latter 
will  show    under  a  ma;4iiifyinr>'  f^'lass. 

In  ])re])ai'in,i;'  coiu])ound  cavities  in  antei"ior  teeth  for  por- 
celain inlays,  we  have  the  same  factoi's  enterinii,'  into  the  cavity 
preparation  which  are  present  in  the  preparation  of  cavities 
for  ft'old   iidays;  that  is: 

1.  The  surgical  or  o])erative  factor  which  means  the  actual 
cutting  of  tooth  structure  (including  the  extirpation  of  the 
pulp)  and  the  ])roper  tilling  and  tr(  atment  of  the  root  canals. 

2.  The  mechanical  or  formative  factor  which  means  that 
mode  of  tooth  structure  cutting  which  brings  it  when  cut  inlo 
the  field  of  ])hysics,  mechanics,  geometry,  and  mathematics. 

8.  The  alterative  factor  which  means  the  factor  tending  to 
ju'oduco  a  change  from  decre])it  or  abnormal  to  a  healthy  con- 
dition l)ecause  of  its  restoration  to  proper  physical  relation  to 
the  surrounding  tissues. 

In  order  to  present  the  three  factors  mentioned,  a  cavity 
for  the  reception  of  a  compound  anterior  ])orcelain  inlay  must 
comply  with  the  following  requirements: 

Tt  must  offer  a  series  of  angles  and  surfaces  best  suited  to 
resist  stress  or  tendency  to  fracture  of  the  tooth. 

Tt  must  ])resent  margins  so  ])rej)are(l  as  to  best  conserve 
the  enamel  structure  of  the  tooth,  which  in  this  instance  means 
that  the  enamel  margins  must  l)e  square  and  not  beveled. 

It  must  offer  a  ready  access  for  the  making  of  the  matrix 
or  for  the  taking  of  the  iin])ression,  in  order  to  construct  a  die 
upon  which  to  swage  the  matrix. 


330  CAST    COLD    AXD    POKCELAIX    IXIAYS 

it  iiiust  offer  a  nteiilive  i'(H'e])ttU'k'  and  su])])ort  to  the 
iiila\'. 

It  must  offer  a  series  of  angles  aiul  surfaces  best  suited  to 
resist  the  constant  tendency  to  dislodge  the  inlay. 

It  must  ])reseut  margins  so  j^repared  tliat  tlie  iinished  op- 
eration Avill  conform  as  nearly  as  possi])le  to  tlie  highest  con- 
ception of  beauty  of  form. 

It  must  iDvesent  a  form  for  the  reception  of  the  inlay  which 


Fi-.  ;!()6. 

sball  bi'iiig  the  \'ai'ious  margins  iiilo  arenas  of  comi)arati\'e  im- 
munities. 

P^)!'  liic  pi'opcr  insi  niiiM'iits,  rcfci'  to  ("liaplcr  \\  l^'ig.  S,  on 
cavity  |)i-('pai  at  ion  for  gold  inla_\s,  wlicrc  also  will  be  found  the 
general    rule-   for  tootli   cutting,  etc. 

Dr.  I*\  1'.  \'an  W'oert,  wbo  is  an  ardent  ad\ocaie  of  llie  ])oi'- 
c(dain   iiila>'  and  of  the   indii'ect    method,   published   a  series  of 


'I'lIK    POKCKI-AIX     IXI.AV 


331 


illustratcil  articles  in  lli«'  Dciihil  llcnis  of  liilcrcsf.  A  iiiiiiibcr 
of  illustrations  and  a  description  of  tliem   is  liei'e   icproduced. 

Fi^'.  30(5,  A,  />',  (',  and  I)  shows  a  method  of  ()l)ta.iniiig  a  se})- 
aration  hetweeii  two  teeth  which  ai'e  to  he  inlayed. 

A  ])iece  of  li^atiii"e  silk  is  doul)led,  and  hy  means  of  a  floss 
silk  loop,  it  is  <;ui(led  throug'li  the  interdental  space  below  the 
contact  point  of  the  teeth  to  be  separated.  A  loop  is  then  tied 
in  the  li<i-atiire  silk  and  the  surjjlus  is  cut  off  with  a  pair  of 
scissors.  The  silk  li<;atui'e  will  absorb  sufficient  moisture  to 
bring  about  a  separation  of  the  teeth. 

In  Fig.  307,  A  and  />',  he  illustrates  a  method  of  separating, 
()!•  more  oi'  less  tilting  back  to  normal  two  teeth  which,  because 
of  extensive  caries,  lean  toward  one  another.     Jle  states: 

"There  are  cases  wliere  extensive  caries  may  have  caused 


FiS-  ;!(i7. 


tlie  leaning  of  two  teeth,  say  a  bicuspid  and  a  molar  (Fig.  307, 
A),  or  two  molars  necessitating  very  extensive  separation  to 
place  them  in  anything  like  a  normal  jiosition.  In  such  cases, 
I  have  obtained  most  satisfactory  results  by  rtmoving  the  su- 
])ei-ficial  decay  and  filling  the  cavities  with  Calxine  cement  (a 
tem])orary  cement),  then  inserting  a  small  piece  of  seatangular 
tent  at  the  point  of  separation,  as  shown  in  Fig.  307,  B. 

"I  l)elieve  this  method  was  devised  ])y  Dr.  Johnson,  of 
Brooklyn.  It  would  ])e  better  to  experiment  with  this  material 
l)efore  putting  it  to  practical  application.  It  is  procurable  at 
most  drug  stores  or  at  any  surgical  supply  house,  and  comes  in 
the  form  of  short  i)encils  in  a  variety  of  sizes.  The  expansion  is 
in  its  diameter  and  not  in  its  length." 

TIkm'c  is  v(M-y  little  occasion  for  the  se]iaration  of  teeth  in 


332 


CAST    GOLD    AXD    POnCELATX    IXLAYS 


gold  inlay  work,  and  it  sliould  ])v  used  with  ^Tcat  caution  wlien 
used  at  all  in  any  kind  of  work  upon  tlic  teeth. 

I  have  seen  many  cases  of  malocclusion  and  subsequent  de- 
struction of  teeth  and  their  supporting-  and  surrounding  tissues 
brought  about  l)y  over  enthusiastic  separation  prior  to  inser- 
tion of  contour  fillings  and  inlays. 

These  restorations  ahvays  made  the  tooth  too  large  mesio- 
distally,  and  thus  forced  all  the  rest  of  the  teeth  in  the  mouth 
out  of  their  normal  lield  of  residence  and  excursion. 

SeiDaration  can  be  avoided  in  most  instances  by  gaining 
free  access  to  the  cavity  from  the  occlusal  surface  and  by  sane 
extension  into  areas  of  comparative  immunity. 


/Sf 


'.mii^^^^M 


F/q.2. 


In,  Fig.  308  Van  Woert  illustrates  the  preferi'ed  manner 
of  preparation  of  a  simple  cavity  for  a  porcelain  inlay. 

For  hair  of  its  depth,  the  cavity  ])resents  walls  ])erpen- 
diculai-  1o  tlic  lloor,  tlic  otlio-  hall'  of  tli<'  walls  being  divergent. 

When  the  iiila>'  is  linislicd,  a  portion  of  its  inner  ])art  is 
ground  off  to  allow  of  its  being  seated,  so  tlial  the  llaring  walls 
\\ill  eoiiie  in  contact  willi  llie  toolli  sli-nctui'c  and  obliterate  as 
iiiucli   as  ])Ossiblc   the  cement    line 

Dr.  Schreici',  of  X'icmia,  I'ccoiiiiiiciids  the  making  of  the 
matrix  of  platinnin  l)\-  placing  llic  Foil  hctwcMii  two  layers  of 
goldbeater's  skin,  1lin.~-  fonniiig  a  ci-adlc  Tor  llic  foil  and  ]*e- 
ducing  the  chances  of  breaking  thi'ough  it  in  tlie  process  of 
swaging.     (See  Figs.  .'JOf),  MIO,  and  lill.) 


TIIK    roltCIM.AlX     1XI>AV 


333 


A  vcTv  iliiii  i-iil)l)(  f  (laii!  will  s('i'\-p  (>(nially  well  as  the 
outci'  layer,  while  a  |)iece  of  lliiii  China  silk  will  take  the 
])la('e  of  _i;()l(  I  heater's  skin   as  tlie  other   pai't. 

If  the  iiiali'ix  is  to  he  roi-iiied  in  the  iiioutli,  the  foil  is 
])larod  l)ot\veeii  the  two  layeis  ol'  sii|)j)()rtin^-  material  and 
slij)j)ed  between  the  teMli,  the  I'uhhei'  dam  or  outer  layer  hav- 
ing heen  h  I't  somewhat  longer  so  that  the  extended  lahial  and 
lingual  jjortions  ol'  it  may  he  gi-as])ed  with  the  lingers  fii-mly 
around  the  tooth  ])resenting  the  cavity. 

With  a  ])aii'  of  Toil  carriers,  the  ends  ol'  which  terminate 
in  a  hall,  })ieces  of  s])nid{  or  cotton  or  small  chamois  disks  are 


Fiff.    oUSil. 


Fie.   311.: 


now  packed  carefully,  and  in  sequence,  into  the  cavity  covered 
l)y  the  three  layers  of  material,  that  is,  the  silk,  the  foil,  and 
the  rubber  dam. 

"When  the  foil  has  been  packed  into  the  cavity  as  deei^ly 
as  the  circumstances  will  permit,  the  rub])er  dam  may  be  dis- 
pensed with  and  the  packing  of  chamois  disks  is  renewed  to 
more  closely  adapt  the  foil  to  the  tooth. 

The  packing  is  again  removed  and  the  almost  conq^lete 
matrix  is  carefully  lifted  from  the  goldbeater's  skin  or  China 
silk,  wliich,  having  served  its  pur])ose  to  act  as  a  cradle  for 
the  delicate  foil,  may  now  als(^  l)e  dispensed  with. 


334 


CAST    G(H.D    AND    TOIU'KI.AI  X     IN  LANS 


Fis:.  :n2. 


/ 


1:1 


Fitr.  .';i.3. 


Fig.  ;ji4. 


Tllli    ronCELAlX     IXl.AV 


335 


Fig.  313. 


Fio.  316. 


Fio-    317. 


Fig.   318. 


CAST    (lOLD    AXI)    POTtCET.AIX    IXT.AYS 


Till'  foil  is  HOW  carcrully  r(  jjlaccd  into  llic  cavity,  the 
labial  and  lingual  sui])lus  of  it  is  tackod  with  sticky  wax  to  the 
respective  surfaces  of  tlie  tootli,  tlio  clianiois  disks,  or  spunk, 
or  wet  cotton  in  the  shape  of  small  halls,  are  again  packed  into 
tlu'  matrix  and  it  is  thus  more  and  more  closely  aihipted  to  the 
floor  and  Avails  of  the  cavity. 

The  j)ackiiig  is  again  removed  and  the  marginal  adapta- 
tion may  be  best  comijleted  with  nonmetallic  instruments  of 
glass,  celluloid,  or  agate.    The  very  hard  tantalum  may  l)e  used. 


y\'r.  ;n9. 


Tlie  gi'catcsl  care  should  he  cxci-ciscd  so  tlial  the  iiuirgius 
i-cnuuii  intact  and  i)resent  a  smootli  unhuckhMl  a])])earance. 

A  small  cone  of  inlay  wax  is  sol'ti'iicd  in  dry  heat,  and  by 
means  of  a  tliin  hioad,  ))lastic  insti'ument,  it  is  caicl'uIlN'  i)acked 
into  the   matrix   and  over  the   margins  of  tlie  cavity. 

Tlic  tacking  of  hard  wax  is  now  i-cinoxcd  IVom  the  labial 
and  lingual  suifaces  of  tli<'  tootli  and  the  Toil  liberated. 

A  blast  of  cold  air  iijxui  llie  lootli   will  cause  the  matrix  to 


'I'lIK    l'()i;('KI>AIX     l.\l,.\V  337 

loosen  fi'om  its  scat  ami  it  may  he  i-cmoNcd  rrom  llic  mouth 
to  bo  can-icd  into  the  iiiNcsl  iiiciil. 

'riic  riii'llici'  proccdiiic  iii\()l\('(l  ill  the  const  nid  ion  of  tlic 
|)()i"cclaiii  iiila_\'  lias  Wccii  I'lilly  (icscril)C(l  in  the  prcN'ious  cha])- 
tcr  on  the  ,i;()hl  iiihi_\'  in  ccinhlnatioii  with  silicate  and  ])()rcc- 
laiii. 

I^'i.i;'.  1)12  shows  a  set  of  ei,i;lit  ,i;lass  rurnishei-s  used  in  adapt- 
ing' a  foil  mati'ix  to  the  cavit>'  in  a  tooth  of  in  a  die. 

Fi.ii,'.  olo  shows  a  set  of  taiitaluiii  insti'umeiits  designed  foi- 
this  j)ur|)()se. 

l^'ii;'.  .'514  shows  a  small  ])latinum  tray  made  by  ])incliin^' 
the  i'our  corners  of  a  i'( ctaii^ular  piece  of  ])ert'orated  ])latiuuin 
30-ft"au,L!,('  tliicl';.  This  tray  may  be  used  as  a  cai'rier  or  coutainei- 
of  the  iuvestin*;'  matei'ial  in  which  the  mati'ix   is  ludd. 

Dr.  Van  AVoei't  hei-e  illustrates  (Fifts.  3ir)-318)  the  mixing 
of  the  silver  amalgam;  (1)  the  invested  imi)ression  of  the  cav- 
ity; (2)  the  die  into  wdiieh  the  matrix  is  to  be  swaged;  (o)  an  in- 
strument to  l)e  used  as  a  swager;  (4)  this  instrument  consists 
of  a  wooden  handle  which  carries  a  pointed  soft  rubber  cone, 
(I  th;'  soft  rubber  end,  h  the  ferrule  of  metal,  c  the  screw  fasten- 
ing this  to  the  wood.  In  Fig.  819  is  seen  the  foil  reposing  be- 
tween the  layers  of  goldbeater's  skin  and  the  application  of 
the  hand  swager. 

The  complete  adaptation  of  the  matrix  to  the  die  may  be 
brougld  about  in  the  S.  S.  AVhite  or  Ajax  swager  as  elaborated 
upon  in  a  previous  chapter. 

Figs.  o2()  to  371  ai"e  taken  from  an  article  published  in  the 
Denial  Items  of  Interest  written  by  Dr.  Van  \Voert,  illustrating 
a  simple  way  of  making  trays  for  carrying  compound  to  take 
imj^ressions  of  different  types  of  cavities. 

Some  yeai's  ago  Dr.  Xies,  of  Brooklyn,  read  a  i)aper  which 
was  published  in  the  Dcntdl  Items  of  Iiiferesf. 

He  attem])ted  in  that  pai)er  to  give  to  the  profession  a 
method  of  making  a  porcelain  inlay  without  the  use  of  a  metal 
matrix,  thus  minimizing  to  a  large  extent,  the  cement  line  in 
these  restorations.  I  feel  that  it  will  be  more  just  to  the  doctor 
to  quote  his  ])a])er  minus  the  introduction,  ])ractically  in  full. 


ooc 


CAST    COT  J)    AXD    P()r>CET.ATX    INLAYS 


Fig.    321. 


CL     '-^-  •'- 


Fi-    324. 


Fig.  320. — A  flisto-labial  cavity  in  a  ccntrfil. 

Fig.  321. — A  strip  of  jilatinoid  l)Ciit  at  aii  oliti'se  aiii;l('  and  perforated  so  as 
to  hold  the  conipouinl  which  is  softened  in  the  tlanio  and  deposited  upon  tiie  im- 
provi.scd  tray. 

Fig.  322. — Carrying  tray  and  eoiiijiouinl  hetween  the  teeth  and  forcing  tlio 
material  into  the  cavity. 

Fig.  323. — Lingual  view  showing  surplus  of  compdund  at  a.  This  surjilus  is 
removed  to  facilitate  removal  of  impression. 

Fig.  324. — Flat  .straight  spatula  to  aiil  in  j)Iacing  and  holding  inijiression 
mat^'rial. 


THE    POIICELAIX    FXLAY 


F'iii.  ;;2s. 


Fig.    329. 


Fie-.  330. 


Fig.  325. — A  labio-disto-lingual  cavity  in  a  lateral. 

Fig.  326. — First  step  in  formation  of  tray. 

Fig.  327. — Second  piece  of  metal. 

Fig.  328. — Improvised  slide  made  from  metal  sjiown  in  Fig.  327  to  fit  into 
that  shown  in  Fig.  326. 

Fig.  329.— Showing  328  on  326. 

Fig.  330. — Shows  328  carrying  compound  and  taking  impression  of  lingual 
part  of  cavity  and  all  of  distal  part.  When  the  compound  ha.s  hardened,  all  sur- 
plus is  removed  from  the  labial  surface  and  this  surface  is  lubricated. 

Fig.  331. — Shows  328  carrying  compound  and  sliding  down  upon  326,  when 
this  has  hardened,  the  slide  is  raised  and  the  impression  is  removed  from  the  tooth 
in  a  lingtial  direction.  The  slide  is  allowed  to  descend  again  until  it  reaches  its 
destination  which  is  fixed  by  the  compound.  This  will  give  an  impression  of  a  cavity 
taking  in  surfaces  of  a  tooth. 


340 


CAST    GOLD    AXD    POECELATX    T:N"LAYS 


Fia-.   332. 


Fio-.  33.- 


Fig.  334. 


Fio-.    335. 


Fig.  33G. 


Fig.  337. 


Fis.    338. 


Fig.  332. — A   linguo-niosial   cavity  in   u   lateral. 

Fig.  333.— The  tray. 

Fig.  334. — The  impression. 

yjg_   oo5__rp],g  plastic   instruments  used   as   an   aid   to   project   the   compound 

into  the  cavity.  •  t    ^,  4.^  ,i 

Figs.  336,  337,  and  338.— Showing  cervical   cavity   in   a  cuspnl,  tlic  partly  antL 

completely  formed  tray. 


THE    roKCKl.AlX    JXLAV 


341 


Fiff.    3:39. 


Fiff.  340. 


Fig:.  341. 


Fig.   342. 


Fie.   343. 


Fie.    344. 


Fig-.   345. 


Fie.  346. 


Figs.  339,  340,  aiul  341. — Showing  a  cervical  proximal  cavity  in  a  lateral  and 
the  partly  and  the  completely  formed  tray  for  taking  impression. 

Figs.  342,  343,  344,  34.j,  and  346. — A  cervical  cavity  in  the  disto-labial  surface 
of  a  molar,  the  partly  and  the  completely  formed  tray  with  compound  in  position  on 

the  tiioth  and  the  ini2)i-os^;i()n   of  the  cavity. 


342 


CAST    GOLD    AXD    rOlUMDLATX    INLAYS 


Fi-  ;:47, 


Fig-.  348. 


Fit;.    34i). 


fm% 


Fig.  3o.3. 


Fi<r.  356. 


Fi-.   357. 


Vign.  347,  348,  349,  .350,  ami  35L— Sanio  as  -Ik.wii  in  i-'i-s.  3Kl  to  :'A\)  on 
opposite  side  of  the  arch. 

Figs.  352,  353,  and  354. — A  disto-ofclusul  ravitv  in  an  ii|i|ici  inii!ai,  tlir  partly 
and  the  completely  formed  tray. 

Figs.  355,  35(),  and  357. — A  laliio-occJiisaJ  cavity  in  a  niolai-,  the  jiartly  and 
the  completely  formed  tray. 


'I' I  IK    I'OKCKLAIX     IXl.AN- 


Fiff.   35J 


Fitr.  a.li). 


Fio-.   360. 


Fig.  361. 


Fig.  362. 


Fig.   363. 


Fig.  364. 


Fig.  365. 


Fig.   366. 


Figs.  358,  359,  and  36U. — Another  type  of  disto-ocelusal  cavity  in  a  molar, 
the  partly  and  the  completely  formed  tray  for  taking  impression. 

Figs.  361  and  362. — -A  mesio-occlnsal  cavity  in  a  lower  mtilar,  and  tray  for 
taking  impression. 

Figs.  363,  364,  365,  and  366. — A  mesio-disto-  occlusal  cavity  in  a  molar,  partly 
and  completely  formed  tray  for  carrying  the  compound  to  take  impression  of  this 
cavity. 


344 


CAST    GOLD    AXD    POlH'Kr^AlX    IXLAVS 


W: 


Fig.   368. 


Fie.   367. 


Fig.   370. 


990 


Fig.   369. 


Fit;.  371. 


Figs.  367,  368,  36!),  :iihI  ;;70.— M.  ().  J),  ciivity  in  l.icuspid,  jiartly  and  com- 
plt'tely  formed  tray  fm  t;ikiiig  iniino-.sioii. 

Fig.  371. — A  liaiiillc  and  .set  of  trays,  or  ciip'^,  wliidi  may  he  triiuiiicd  to  suit 
the  case,  dcvi-sed  l.y  Dr.  ]{oacl:  to  fai-ilitati'  tln'  taking  of  iiii))rcssioiis  of  various 
cavities. 


Till-:  roiu'Ki.Aix   i.\i,Av  ?A^) 

"111  tlio  method  of  l)iirnisliiii*;-  f;ol<I  or  ])latiiniin  foil  di- 
rectly into  tlic  cavity  tlicrc  is  a  i)('rv('-i'ackii)<;'  tcdiousness  to 
the  operator  and  palieiil-  not  to  iiicnlioii  pain-  the  fre(pieiit 
tearing  of  the  matrix  when  almost  in  ])lace;  the  uncertainty  of 
liaving  it  adapted  while  heating,  and  lastly,  its  fatal  defect — 
that  of  war])ing,  of  yicdding  to  tlie  pressure  exei'tcnl  during  the 
contraction  of  fused  ])orcelaiii,  are  all  defects  inliereiit  in  those 
metallic  matrices. 

"Swaging  into  a  model  of  the  cavity  made  of  amalgam, 
S])ence  or  .Mellotte  metal  ol)tained  by  the  impression  method, 
while  less  trying  to  the  ])atient  and  o])erator,  does  not  relieve 
the  defects  that  obtain  in  the  ])orc(*lain  inlay  when  using  a 
metallic  matrix.  There  is  the  contraction  of  the  wax — not  as 
great  as  has  ])een  stated,  I  believe  witli  consequent  smaller  cav- 
ities in  the  dies;  the  contraction  of  the  dies  themselves  in  some 
of  the  materials  used;  the  additional  space  occupied  by  the 
matrix;  the  expansion  of  the  matrix  when  heated.  Granting 
that  none  of  these  usual  errors  have  crept  in,  the  matrix,  after 
leaving  the  die,  is  still  war])ed  in  the  fusing  and  contraction 
of  the  porcelain.  Byram,  speaking  of  lal)ial  and  buccal  and 
four-wall  cavities,  says:  'such  forms  of  cavities  cannot  be  pre- 
pared so  that  the  matrix  can  be  burnished  into  the  cavity  and 
the  inlay  coin])ensate  for  the  space  of  the  matrix,  unless  it  be 
constructed  with  frail  margins  of  porcelain  which  lack  edge 
strength,  and  are  so  thin  that  change  of  color  is  noticeable 
along  those  margins.' 

"Xor  is  there  relief  found  in  swaging  over  the  cavity. 
This  method,  although  i:)ermitting  a  more  accurately  fitting  in- 
lay than  any  in  use,  because  of  the  heavier  foil  it  is  j^ossible  to 
use  (the  thickness  making  no  difference  in  this  method,  the 
thicker  matrix  offering  stoutin-  resistance  to  the  shrinking  por- 
celain, but  not  enough),  does  not  ])revont  this  metallic  matrix 
also  being  warped  in  the  fusing.  The  advantage  of  swaging 
should  be  directly  over  the  first  impression  of  the  cavity,  tak- 
ing in  oxyphosphate  of  zinc  or  copper  when  jjossible. 

"It  does  not  matter  whether  the  metallic  matrix  is  directly 
burnished  into  the  cavity  or  swaged  in  or  over  dies  made  by  the 
impression  method — the  fatal  defect  of  warping  is  inherent  in 
))oth   methods.     'J'lie    invested   ^olil   matrix   has  no   advantage 


34()  CA^^T    GOLD    AXD    PORC'ELAIX    INLAYS 

over  tlu'  iiiiiiiv(^st('(l  j)latimiiii  one  in  the  matter  of  wari)iii<;'. 
The  Price  method  of  burnishiiif^'  the  iDhitiimiii  or  gohl  foil  over 
a  stone  model  and  baking  in  the  matrix  while  it  is  in  placQ, 
on  the  model  has  the  same  defect  of  a  warped  matrix,  due  to 
the  fused  jjorcelain  contracting  while  cooling.  Xone  of  the  in- 
vestment furnished  for  this  purpose  could  hohl  the  delicate  foil 
against  the  tension  of  shrinking  porcelain. 

"Every  metallic  matrix  takes  up  an  a])precial)le  amount 
of  space,  ranging-  from  1/500  to  1/1000  of  an  inch,  which  means 
an  inlay  just  that  iinicli  too  small  mid  a  cement  line  of  that  thick- 
ness to  take  its  place,  which  often  mars  the  heauty  of  this  work. 
There  is  the  possi])le  distortion  caused  by  the  expanion  of  the 
gohl  and  ])latinuiii  themselves.  This  may  also  contribute  to  a 
poorly  fitting  inlay. 

"I  have  felt  that  tapered  cavity  i:)reparation  could  not  al- 
ways be  exact  enough  to  do  the  work  some  of  us  have  imagined 
it  did.  For  the  jjlan  to  be  entireh'  satisfactory,  it  is  necessary 
that  the  margins  of  the  porcelain  inlay  project  beyond  the  nat- 
ural surface  of  the  tooth,  so  that  when  the  matrix  foil  is  re- 
moved, the  inlay  will  sink  down  and  l)e  just  right.  Where  it 
is  contoured  even  with  the  surface  of  the  tooth  before  the  foil 
was  distui'bed  it  would  sink  helow  the  surface  after  the  foil 
has  been  removed,  or  if  built  wp,  it  could  only  be  at  the  center 
and  a  peak  of  cement  would  result.  The  difference  between 
diameters  of  i)uli)al  surface  and  outside  surface  might  also 
affect  shrinkage  unevenly.  The  smallest  deviation  from  a  geo- 
metric taper  might  prevent  the  proper  seating  of  an  inlay  made 
by  this  method. 

''Having-  briefly  mentioned  the  iiilK^-cnt  nK'chanical  erroi's 
that  obtain  throughout  the  impression  and  die-making  i)r()cess, 
which  are  latei-  inliciilcd  by  the  metallic  mati'ix  and  its  jjroduct, 
the  ])or('('hiiii  filling,  wiiicli  also  contracts,  it  must  be  apparent 
that  some  form  of  mati'ix  is  needed  that  will  be  fi-ee  fi-om  the 
errors  which  the  metallic  one  possesses.  A  matrix  is  needed 
that  will  take  a  sliai-j)  impi-ession,  withstand  the  intense  heat 
of  a  higli-fusing  jtoi'CM'lain,  and  maintain  its  sjiapc  in  this  heat 
witiiout  warping;  on<'  that  slightly  ex})ands  when  set  and  does 
not  conti'act,  noi-  on  di-yiiig  become  "f)oi-oiis;  a  mati-ix  that  will 
j)resent  smootli  surfaces,  that  will  not   xitrily  or  liisc  at  highest 


TIIK    I'OIU'KI.AIX     IXLAV  347 

tension  of  sliiinkiii^-  jtoi'ct'Uiin  wliih*  eooliiif^',  and  iinally,  wlicn 
tlie  inlay  is  ))ak((l,  a  matrix  tliat  can  he  decomposed,  permitting 
the   inlay  to   he   fi-ccd    IVoiii    its  iii\'esliiieiit. 

"These  (pialities  must  he  contained  in  the  ideal  matrix,  and 
are  eml)odied  in  th.e  jxncchun  matrix  that  I  give  you  tonight. 
I  give  yon  tonight  a  matrix  tliat  will  not  warp;  that  has  yield- 
ing walls;  that  does  not  tear;  that  does  not  distort;  that  occn- 
])ies  no  ])art  of  the  cavity  s])ace;  that  admits  of  addition  and 
suhtraction  of  ])orcelain;  and  changes  of  j^orcelain  shades  to 
your  heart's  content;  that  allows  repair  Avlien  cracked  or 
cliippe(l;  that  ])('iiiiits  foiiiiat ion  of  jxM'fect  retention  cavities 
and  insertion  of  metallic  and  ])orcelain  pins  and  retainers;  that 
has  a  slight  exj^ansion  on  setting  and  no  contraction  on  cool- 
ing; and  owing  to  the  stability  of  the  matrix,  resists  the  shrink- 
ing porcelain,  holding  it  to  its  maigins  and  walls,  tlierel)y  pro- 
ducing a  perfectly  adapted  inlay,  thus  minimizing  the  cement 
line.     Let  us  begin  and  make  an  inlay  with  this  matrix. 

"Conmience  with  me  by  generously  separating  the  teeth  to 
secure  space  for  work.  Selecting  a  German  silver  or  celluloid 
strip  the  width  of  the  tooth  and  about  five  inches  long,  bring  the 
ends  carefully  together  and  jjlace  in  its  base  a  piece  of  soft 
rubber.  Pressing  the  walls  of  the  strip  together,  insert  this 
between  the  teeth  to  be  filled,  the  loaded  end  on  the  lingual 
side,  and  then  draw  it  uj)  tightly  against  these  surfaces  of  the 
teeth,  thus  molding  it.  This  I  always  try  to  do  before  trinnning 
the  walls  of  the  cavity.  We  now  withdraw  it  pending  our  cavity 
preparation.  Isolate  the  tooth  or  teeth  Avith  a  rubber  dam; 
desensitize  it  in  any  manner  you  see  tit. 

"I  use  ethyl  chloride  put  ujd  in  metal  tubes.  I  hesitate  to 
mention  its  use,  since  one  of  my  dear  friends  to  whom  I  recom- 
mended it,  almost  blew  himself  up  by  handling  it  improperly. 
Before  applying  the  ethyl  chloride,  the  temperature  of  the  tooth 
should  be  lowered  by  gradually  chilling  with  a  i)ledget  of  cotton 
dipped  in  ether,  placed  in  the  cavity  and  evaporated  by  a  con- 
tinuous spray  of  compressed  air  under  high  pressure.  The  tube 
of  ethyl  chloride,  which  in  the  meantime  has  been  cautiously 
heated  as  warm  as  can  comfortably  be  held  in  the  hand,  is 
o])ened  and  the  s])ray  is  thrown  intermittently  on  the  tip  of  the 
tooth,  gradually  working  it  u])  toward  the  neck.    The  i)ulp  seems 


348  CAST    GOLD    AND    TOIK'KLAIX    IXLAYS 

to  recede  iiiuler  this  Ircatiiii'iit  and  is  not  injui'ed.  1  have  used 
this  luetliod  for  many  years,  and  liave  not  knoAvn  a  jjulp  to  be 
destroyed  by  it.  Tlie  j^rocess  takes  Init  a  minute.  I  mention 
desensitizing-  because  it  is  absolutely  necessary  to  cut  deeply 
and  freely  to  obtain  frictional  surfaces  for  iDrojjer  retention. 

"AVe  now  rapidly  prepare  our  cavity  with  burrs,  small 
stones  and  ijolishing  disks,  doing  this  work  under  a  powerful 
glass  known  as  Loojjc  Stereoscopique,  which  has  the  great  ad- 
vantage of  focusing  the  vision  of  l)oth  eyes  on  a  single  j^oint, 
and  which  can  be  worn  over  glasses,  or  glasses  can  be  built 
into  it.  After  preparing  our  cavity  carefully  we  drill  in  a  safe 
l)lace  a  small  depression,  which  reappearing  in  our  inlay  leaves 
on  our  inlay  a  small  pai)illa,  which  serves  as  a  guide  in  jDlacing 
it.  Then  we  paint  the  cavity  with  a  small  camel 's-hair  brush 
di])ped  in  pure  white  vaseline  oil — not  vaseline  or  crude  petro- 
leum. In  those  cases  when  there  is  much  saliva  this  coating- 
is,  of  course,  unnecessary.  Much  has  l)een  said  against  the  use 
of  such  sei^arating  oils,  but  when  one  considers  the  daily  food 
l)aths  of  fats  and  oils  that  teeth  are  treated  to,  I  can  see  no 
harm  in  their  use.  If  there  is  harm  in  the  use  of  petroleum,  it 
must  largely  be  due  to  the  wax  that  manufacturers  add  to  give 
it  l)ody.  Of  course,  this  objectionable  ingredient  does  not  exist 
in  pure  vaseline  oik 

''Here  we  depart  from  one  of  the  well-known  ways  of  mak- 
ing an  inlay,  namely,  tliat  of  l)urnisliing-  the  platiiumi  of  gold 
foil  directly  into  the  cavity.  Following  the  impression  method, 
only  so  far  as  taking  the  impression  in  wax,  or  other  impression 
compounds,  we  proceed  to  take  our  impression  in  a  wax  which 
I  have  had  especially  pi-epared  for  tlie  j)Ui-])ose  of  taking  ini- 
jnx'ssions  of  the  anterioi-  teeth,  largely  without  the  use  of  im- 
l)ression  cui>s  or  traxs.  .M>'  ol)J(  ct  in  doing  awa>'  with  the  ti'ay 
where  possible  is  that  the  space  it  occnpies  is  ol'teii  soi'ely  needed 
to  successFull)'  w  il  lidraw  the  ini|)ression.  The  wax  I  have  had 
jji-(^j)ared  is  tongli,  nondastic,  and  coiiti'acts  oidy  slightly,  which 
is  easily  coi-recl<*<l  hy  Ihe  expansion  which  tak'es  ])lace  when  we 
reheat  the  im]n'ession  to  its  workahle  temperatui-e.  It  takes  an 
impression  as  shai'])  as  any,  hums  up  wilhoul  a  residue,  and 
lias  a  liigli  melt  ing  polnl .  ( )1  Iht  waxes  on  Hie  mark  el  1 1ia1  hui-n 
up   without   a   residue   ai'e,    wiieii    \\arni('(l,    foun:!    to   he   elastic 


TIIK    I'OI'.CKI.AIX     IXLAV  349 

and  sli('k\-,  adlicriii,^-  to  Ihc  trclli;  tlu'V  arc  hrilllc  wlicu  cliillod 
and  iiicll  at  loo  low  a  Iciiipci-at iii'c. 

"i  wish  (o  (■iii|)liasiz('  tliat  it  is  necessary  tliat  a  wax  have 
a  lii<;li  inciting  point,  lor  it  permits  greater  lieat  to  l)e  used  in 
drying  tlic  poured  impression,  which  reduces  the  liability  of 
distortions  that  frequently  o])tain  when  a  wax  witli  a  low  melt- 
ing ])()int  is  used.  I  am  ))artia!  to  the  wax  iini)ression,  and 
while  recognizing  that  wax  expands  when  heated  and  contracts 
wlien  chilled  under  noi'inal  conditions,  I  am  convinced  that  the 
conditions  that  obtain  in  taking  an  impression  of  a  cavity  are 
not  those  that  ohtain  when  a  bar  of  wax  is  mcnisured  in  a  water 
hath  without  i)ressure  l)y  a  micrometer  arranged  expressly  for 
that  purj^ose.  In  the  case  of  the  impression  there  is  always  the 
forcing  into  the  cavity  of  new  wax  ]jy  heavy  pressure  to  com- 
pensate for  the  shrinkage  in  cooling.  This  movement  of  wax 
is  possible  even  at  normal  room  temperature.  It  is  admitted 
that  the  contraction  of  gold  can  ])e  minimiz((l  by  pressure.  The 
same  nmst  be  true  of  wax  if  clinical  results  count  for  anything. 

"To  continue,  we  take  a  small  piece  of  wax,  a  trifle  larger 
than  the  cavity,  which  we  soften  in  a  small  bowl  of  hot  w^ater, 
held  close  to  the  patient's  face.  Now  force  the  wax  into  the 
prepared  cavity  with  fingers,  next  using  a  steel  spade-like  blade, 
wdiicli  is  passed  between  the  teeth  for  pressure  and  separation, 
introducing  now  the  German  silver  or  celluloid  strip  previously 
])repared  for  this  jnirpose,  which  we  tightly  dra^v  against  the 
wax,  and  with  strong  lateral  pressure  force  the  wax  into  the 
cavity,  making  our  tooth  contour  at  the  same  time.  AVlien  too 
large,  we  cut  it  away  and  trim  with  a  sharp  instrument,  always 
reheating  the  wax  with  a  hot  napkin  to  remold  it.  Some  of  the 
inlay  waxes  can  be  used  for  impr(^ssions.  The  contraction  of 
these  materials  is  said  to  be  considerable,  but  I  question  whether 
the  greater  part  is  not  overcome  by  the  forcing  of  more  wax 
into  the  cavity  as  it  contracts  in  cooling,  and  later  when  ex- 
])anding  the  impression  by  heat.  In  all  bicus])ids  and  molars 
I  jjrefer  a  cup  to  hold  my  impression  material  and  furnish  me 
means  of  pressing  hoiue  my  wax.  AVith  pressure  at  right  angle 
we  secure  perfect  adaptation  of  the  imi)ression  material  to  our 
edges,  using  i3referal)ly  cups  made  for  each  case  of  platinoid  of 
28,  30  or  35  gauge. 


350  CAST  COLD  AXI)  PORC'KLAIX  IXLAYS 

"Tile  set  seen  in  my  (>.\liil)it  has  kindly  been  made  for  nie 
hy  ])r.  F.  T.  Van  Woert,  of  Brooklyn.  Some  of  the  brass  cups 
devised  by  Dr.  Price  have  many  excellent  features.  These  I 
have  also  mounted  for  your  inspection.  The  use  of  modeling 
comiDounds  is  not  practical  with  the  porcelain  matrix,  because 
this  matrix  material  takes  time  to  set  and  is  hardened  by  heating. 
Many  of  the  impression  compounds,  which  contain  shellac  with 
whiting  as  a  base,  swell  and  form  gases  when  heated,  which 
distort  the  impression  beyond  all  usefulness  before  the  matrix 
has  had  time  to  set.  It  shall  give  you  later  in  my  paper,  how- 
ever, a  convenient  material,  which  would  be  ideal  could  its  con- 
traction be  controlled,  that  can  be  used  with  these  impression 
compounds. 

''A  splendid  impression  could  also  be  taken  with  oxyphos- 
phates.  Before  inserting  cement  in  the  cavity,  test  withdraw- 
als should  first  be  made  with  modeling  compound.  After  all 
the  undercuts  shown  to  be  present  have  been  removed  or  filled 
with  cement,  the  cavity  is  jDainted  with  vaseline  oil  and  the  ce- 
ment pressed  into  the  cavity  with  instruments  dipped  in  alco- 
hol. The  impression  should  be  withdrawn  as  soon  as  it  is  suf- 
fteiently  hard  to  handle.  An  advantage  of  this  material  is  that 
it  can  be  fractured  for  withdrawal  and  later  united  l)y  addi- 
tional cement. 

"AVhere  it  is  possible  to  take  the  bite  and  imiDression  to- 
gether, it  is  advisable  to  do  so,  the  wax  filling  made  first  and 
i-enioved  adhering  to  the  bite. 

*'AVe  i)roceed  in  the  case  of  wax  impressions  with  cups  to 
support  the  frail  edges  of  the  inij)ression  by  embedding  it  in  a 
plate  of  softened  wax  whose  melting  point  is  lower  than  the 
piece  whieh  we  are  investing.  This  procedure  is  necessary  to 
])rev(Mit  tliese  tiny  impressions  from  being  engulfed  and  dis- 
aj)]jearing  l)elow  the  surface  of  the  pouring  comijosition.  AVith 
a  tliermometer  as  a  guide,  we  i)lace  our  imjoression  next  to  a 
stove  and  heat  it  almost  to  the  temperature  at  which  it  was 
when  we  introduced  it  into  the  cavit}-.  This  temperature  was 
determined  l)y  a  bath  thermometer  innnersed  in  the  same  cup 
with  tlic  wax.  One  reading  suffices  for  the  whole  box  of  wax. 
Tlie  wax  imjjressions  need  no  ticatmcnt.  Tlie  cement  imj^res- 
sioiis,  howevci',  are  (•over((l  wilii  a  solution  of  gutta  to  pi'event 


Till-;    I'ol'.CKl.AlX     IXLAV  .Sf)! 

clicmical  adioii  hctwccii  llic  iiiali'ix  inalcrial  and  llic  iiiijji'cssioii 
inatci'ial. 

"We  liaNc  HOW  i-caclicd  tlic  ])()iiit  wlici-c  wo  abandon  the 
niotallic  iiialiix  I'oi-  llic  ])()i'celain  matrix.  Jt  is  a  ijorcolain 
matrix  l^ecausc  the  malci-ials  that  enter  into  its  com])osition  are 
tliose  tliat  enter  into  tlic  coinposition  of  jioicclain,  namely,  sili- 
cate of  alumiiiniii  and  free  aluininnni  and  lime,  which  on  treat- 
ment witli  phos})horie  acitl  form  ])lios})hate  of  lime  and  alum- 
inum, which  <;ive8  this  mixture  settin*;'  qualities.  The  difference 
between  tliis  matrix  material  and  many  porcelains  is  the  a1)- 
sence  of  the  fehlspar  and  the  Huxes,  which  are  incoriDorated  in 
the  porcelains  to  increase  their  fusibility;  for  example,  such  sub- 
stances as  sodium  carbonate,  potassium  carbonate,  sodium  bo- 
rate, or  glass.  These  tluxes  would  be  fatal  to  the  jDorcelain 
matrix,  because  their  presence  would  cause  the  aggregates  in 
its  composition  to  vitrify  or  fuse,  thus  coat  them  with  an  insol- 
uble glaze,  making  it  very  difficult  for  the  deconii)osing  mixture 
to  enter  the  interstices  between  the  atoms  of  the  matrix  to  dis- 
integrate it.  The  phosphate  of  lime  and  aluminum,  which  is 
slowly  soluble  in  the  decomposing  mixture,  would  be  protected 
by  the  coating,  and  would  not  be  acted  upon,  thus  making  it 
impossible  to  free  the  inlay. 

"The  matrix  powdei's  are  linely  ground,  separately  mixed 
in  the  right  proportions,  and  heated  to  a  bright  red  heat  to 
exi^el  all  water,  both  free  and  combined.  The  mass  is  then 
tinely  ground  to  impalpable  powder  and  is  ready  for  nse  hy 
mixing  with  dilnte  glacial  phosphoric  acid. 

"I  found  this  material  so  difficnlt  to  proj^erly  prepare,  with- 
out adequate  laboratory  facilities,  that  it  has  been  necessary 
for  me  to  secure  the  services  of  a  chemist. 

"AVe  are  now  prepared  to  pour  our  matrix.  On  a  glass  five 
by  tive  we  place  onr  materials,  mixing  thoroughly  with  hone, 
glass,  or  gold  spatula,  to  a  thick  workable  consistency.  AVith 
a  tiny  brush  we  ])ick  up  this  mixture  and  paint  our  impression 
with  it,  adding  thereto  until  the  impression  is  coated.  Xow 
thicken  the  mixture  and  till  in  the  impression  with  a  thicker 
mix.  Wrai)  the  impression  in  bibulous  pajDer  and  gently  press 
the  mixture  against  the  impression.  Leave  it  in  this  condition 
for  a  few  hours  to  set,  after  which  place  it  near  a  source  of 


O0_  CAST    COLD     VXD    PORCELAIN    IXLAYS 

heat  of  some  kind  and  allow  it  to  dry  for  a  few  hours  longer. 
Li  the  drying  the  advantage  of  having  a  wax  that  fuses  at 
high  temi^erature  is  apjjarent,  for  it  is  possible  to  use  a  greater 
heat  in  drying,  hence  the  better  adhesion  of  the  material.  Now 
l)lace  the  i^oured  imi:)ression  in  or  on  a  stove  and  gradually 
lieat  it,  to  burn  ujj  the  wax,  continuing  this  heat  until  the 
model  is  hard.  The  matrix  is  allowed  to  cool,  and  if  too  thick 
is  ground  down  on  a  carborundum  stone.  By  grinding  the 
matrix  as  thin  as  possible  the  decomposing  mixture  has  less 
material  to  penetrate  when  freeing  the  inlay;  the  thinner  it  is, 
the  more  quickly  the  heat  penetrates  the  matrix  and  fuses  the 
l)orcelain.  In  low-fusing  j)orcelains  the  grinding  has  the  ad- 
ilitional  advantage  of  so  23ermitting  us  to  form  the  base  that  we 
can  direct  our  porcelains  to  flow  where  we  wish. 

"AVlien  the  mold  is  cold,  we  carefully  ipmiit  the  outer  sur- 
face with  a  fine  camel's-hair  brush  right  up  to  the  marginal 
edges  of  the  cavity  with  a  solution  of  gutta,  which  I  have  pre- 
pared for  the  i^urpose  of  varnishing  teeth  to  protect  them  from 
the  destructive  action  caused  by  the  wearing  of  regulating  ap- 
pliances. This  solution  I  have  adapted  to  the  additional  pur- 
pose of  varnishing  my  matrix.  It  is  made  from  ))alata  gum, 
from  which  the  resins  have  been  extracted  by  the  usual  wash 
roll  jjrocess.  It  is  then  dissolved  in  bisulphide  of  carbon,  washed 
in  acetone,  filtered  and  redissolved  in  chloroform.  This  makes 
a  pure  solution  of  gutta,  with  more  body  and  tougher  than 
before  obtainable.  This  gutta  has  the  valuable  faculty  of  swell- 
ing under  heat,  and  if  wlion  filling  your  matrix  any  unfused 
porcelain  should  hajipen  to  accidentally  extend  l)eyond  your  cav- 
ity margins,  the  swelling  gutta  largely  dislodges  the  superfluous 
porcelain  and  prevents  its  adhesion  to  the  outside  of  the  mold. 
Great  care  should  be  exercised  to  ])re^'ent  this.  After  each  bak- 
ing tlie  outei-  siii'face  of  llic  mold  is  rex'arnished. 

"We  now  ])re2:)are  to  lili  llic  inatiix  with  porcelain.  There 
are  Tiuiiiei'ous  ways  of  doing  liiis,  and  every  man  prefers  his 
own,  l)iit  in  this  pi'ocess  it  is  iiecessai-y  that  the  first  layer  in 
dii-cf't  ('(iiitact  with  tlic  inati'ix  he  lirsl    I'liscd  oi'  gla/cd, 

"it  is  higldy  iiiij)oi-taiit  with  the  ])orc('hiiii  mali-ix  that  the 
mold  be  heated  gradually  and  thoroughly,  'i'lic  poi-cclain  should 
be  fused  bv  receiving  its  heat   IVoni  contact    witii  the  walls  of 


THE  poih;klaix   ixlav  353 

llic  iiiati'ix  I'ntlicr  lliaii  IVoiii  direct  rui-iiacc  licat  exerted  on 
tlie  ])oi'('elaiii  itself.  If  tlie  mold  lias  been  iin])roporly  heated 
the  tendency  of  the  porcehiin  is  to  hall  iij)  and  lea\'e  the  cavity 
margins,  making'  it  necessary  to  fill  in  between  the  inlay  and 
matrix — a  tiling-  whicli  we  sliould  seek  to  avoid.  Tf  tlie  mold 
is  ])ro])erly  heated,  the  tendency  of  the  ])orcelain  is  to  cling  to 
it  and  t'orni  a  ])ert'ect  ada])tati()n  to  the  cavity  surfaces.  To 
bring  al)out  this  result  a  clay  hood  to  cover  the  matrix  while 
baking  is  ahsolutely  necessary,  for  it  prevents  direct  action  on 
the  i3orcelain  and  enables  us  to  hold  back  the  fusing  of  the 
porcelain  until  the  matrix  is  properly  heated.  In  large  con- 
tours or  long  cavities  a  thin  film  of  baked  porcelain  sliould  first 
cover  the  model;  then  cervical  and  incisal  ends  are  filled  and  , 
baked,  the  intervening  space  being  filled  later.  Filled  in  this 
way,  I  have  found  that  the  porcelain  does  not  shrink  away  from 
the  interior  surface  of  the  mold,  Init  on  the  contrary  clings  to 
the  same  tenaciously,  so  that  if  any  shrinkage  takes  j^lace,  it  is 
not  at  the  point  Avliere  the  inlay  contacts  with  the  walls  of  the 
cavity,  but  is  in  the  interior,  which  is  later  filled  in  and  the 
piece  baked.  As  it  is  gradually  heated  so  it  is  gradually  cooled. 
Additional  jiorcelain  is  now  added  Avitli  brush  and  spatula, 
pressing  and  forming  it  Avith  fingers  and  bibulous  paper.  The 
addition  of  gum  tragacanth,  mixed  in  the  water  used  to  wet  the 
porcelain,  is  a  great  help  with  some  high-  and  medium-fusing 
bodies.  I  recommend  that  medium  fusing  porcelain  be  used, 
because  there  is  no  liability  of  checking  from  contraction  with 
these  bodies,  while  with  low-fusing  porcelains  there  is,  unless 
the  cavity  is  almost  filled  with  quartz.  This  trouble  with  low 
fusing  bodies  seriously  threatened  the  success  of  my  work  until 
I  substituted  medium-  and  high-fusing  porcelains.  The  fact 
that  cracks  do  not  occur  with  low-fusing  jiorcelains  when  baked 
in  a  metallic  matrix  is  proof  that  the  matrix  yielded  and  was 
distorted  as  the  porcelain  contracted.  Did  the  walls  of  the  me- 
tallic matrix  hold  firm,  cracks  would  also  be  common  in  this 
type  of  inlay.  High-fusing  porcelains  contain  a  high  percentage 
of  silex  and  kaolin.  Both  of  these  materials  are  virtually  con- 
stant, adding  compression,  strength,  and  stability.  The  high- 
fusing  porcelains  having  far  less  contraction  than  the  low-fusing 
porcelains,  it  must  follow  that  the  men  who  have  been  woi'king 


354  (.'AST    COLD    AXi)    POIH'KI.AIX     IXLAVS 

\\\{\\  till'  liii;li-riisiii,u'  |)()rc'(  laiiis  ]\i\\v  iiiadi'  more  iieai'ly  perl'ect 
Uttiiig  inlays,  for  tlicre  lias  been  less  shrinkage  to  their  material, 
and  consequently  less  distortion  to  tlieir  matrices. 

*'Tlie  ])ieee  liavinii,'  heen  re])eatedly  carried  to  a  high  bis- 
cuit iov  contraction — and  there  are  men  who  claim  it  must  be 
carried  to  a  glaze  to  secure  maxinumi  shrinkage — allowance 
should  be  made  for  the  lightening  of  the  selected  shade  by  the 
re])eated  tirings,  and  a  porcelain  should  be  chosen  a  few  shades 
darker  than  the  tooth.  Tliis  rule  holds  with  labial  cavities,  but 
should  not  be  ajjplied  to  api:>roximal  cavities,  where  the  shade 
should  never  be  dai-ker  than  the  tooth  in  the  mouth,  because 
when  exactly  matched  in  this  location  it  looms  darker  than  the 
tooth.    It  should  l)e  a  tritle  lighter. 

"Shaping  and  contouring  should  now  be  done,  and  there 
is  no  safer  means  than  the  carborundum  disk,  grade  No.  00.  It 
cuts  cleanly  and  smoothly,  and  will  not  chip  the  inlay.  Ruby, 
garnet,  emery,  or  sand  disks  should  be  used  in  inlay  work.  If 
in  the  final  fusing  it  is  not  the  exact  shade  you  seek,  the  glaze 
may  be  ground  off  with  the  same  carborundum  disk,  No.  00,  and 
a  better  shade  of  ])orcelain  applied  and  fused.  The  inlay  can 
also  be  removed  fi-om  the  matrix,  tried  in  the  mouth,  rein- 
vested and  finally  glazed.  But  tliis  takes  time.  As  no  porce- 
lains have  a  definite  fusing  point,  they  should  be  gradually 
heated.  Tlie  tliorougli  heating  of  the  mold  should  always  be 
done  before  the  point  of  high  biscuit  is  reached. 

''Earlier  in  my  ])ap(M-  I  ])romised  to  give  j^ou  a  material 
that  can  be  used  as  a  matrix  mold,  to  pour  into  modeling  com- 
pound iin])ressions,  to  forin  matrix  molds  to  be  used  with  low- 
fusing  porcelains.  This  material  is  no  other  than  the  oxyj^hos- 
pliate  of  cement  that  we  have  had  on  our  shelves  the  greater 
pai't  of  oni-  lives,  it  is  mixed  in  the  usual  way  and  woi'ked  into 
the  compound  impression,  covcrccl  with  bibulous  ])a])er  and 
pressed  home  Al'tci-  setting  It  is  slowly  di-ied  over  a  Bunsen 
bui'ner  and  is  i-ead>'  I'oi-  use.  The  melting  ])oint  of  this  oxy- 
phos])hate  is  a  little  ovei-  1,700  F.,  var>'ing  slightly  with  the  dif- 
ferent cements.  As  low-rnsing  poi-celains  have  no  fixed  melt^ 
ing  jtoint,  by  slowly  heating  tlie\- can  be  glazed  at  about  1,600°  F., 
according  to  my  ])yi-()meter.  The  compound  impression  should 
!)('  expanded  betoi-e  using  to  connteract  the  sliriid<age.     in  mix- 


TIIK    I'OltCKI.AlX     IXL.W  355 

in,i;'  llic  ('('iiiciit,  as  iiiiicli  powder  should  We  iiicoi-pofalcd  as  ])()s- 
sihlc.  I  have  used  llai'xard,  Ash  cV  Sous'  ('.A.S.,  \\vv('.\  and 
Ames.  Other  ceiiieiils  may  he  Just  as  ^ood  for  this  pui'pose, 
but  1  liave  never  tried  them.  'I'liis  is  coiiveiiieiit  material  tliat 
you  all  have  in  your  offices,  and  will  alToid  you  an  oiJpoitunity 
to  test  for  yourself  the  process  1  am  ,i;i\iii,<;'  you  tonight.  If 
some  of  you  couhl  (h'vise  a  means  of  ovei'comiug  slirinkage  in 
this  material,  it  wouhl  suj)])laiit  all  others  as  a  matrix  for  low- 
fusing  porcelains  in  combination  with  silex. 

"This  matei'ial  ])roduces  a  beautiful  inlay,  and  there  is  an 
innnense  saving  of  time  in  its  use.  Its  shi-inkage  and  the  dan- 
gei'  of  melting  it  without  a  ])yi'ometer  are  its  disadvantages. 

*'I)r.  Price's  Stone  ^lodel,  while  perfect  for  this  jnu'ioose 
in  man}'  resi)ects,  is  today  almost  imi)ossible  to  dissolve.  It 
also  melts  below  the  ])oint  of  high-fusing  porcelains.  If  he  could 
only  overcome  these  two  difficulties,  there  would  be  a  wider  field 
for  this  valuable  material. 

"Undercuts  are  formed  on  the  matrix  by  additions  of 
matrix  material  that  leave  depressed  recesses  for  cement,  while 
metallic  tubes  and  i)ins  baked  in  the  inlay  can  also  l)e  usd. 
Cubical  crystals  of  quartz,  a  material  with  minimnm  of  expan- 
sion and  contraction,  I  frequently  nse  to  form  a  crystal  sur- 
face for  adhesion  of  cement.  The  cement,  encircling  with  crys- 
tal, not  only  furnishes  an  arc  action  by  binding  around,  but 
also  adheres  to  each  particle,  and  by  its  own  strength  gives 
snjiport  to  the  porcelain  that  the  voids  between  the  crystals 
might  l)e  thought  to  have  weakened. 

"We  know  that  maxinnun  density  is  maximum  strength, 
yet  where  compression  strength  is  sought — as  in  concrete  work, 
for  instance — the  maxinnim  of  stone  properly  shaped  with  a 
mininmm  of  cement  is  reconnnended  l)y  experts  in  that  line 
and  should  hold  true  in  our  work.  The  crystals  of  quartz  are 
rolled  in  a  paste  of  porcelain  and  i^laced  in  the  matrix  some 
distance  from  the  margins  and  as  carefully  baked  as  if  they 
formed  the  inlay.  When  tinished  and  cooled  the  voids  should 
be  filled  with  chalk  or  cement  to  i)revent  the  porcelain  tillering 
throngh  them  and  filling  them  up, 

"The  i)or('elain   is  now  tilled  in,  as  experience  will  guide 


356  CAST    GOLD    AXD    PORCELAIX    IXI.AYS 

you,  l)ak('(l  in  tlic  ])i'escril)CHl  way,  and  slowly  and  .^I'adnally 
cooled  ill  the  inuflie  witliout  o])eninf;-  it. 

"When  I  readied  this  stej)  in  workino-  out  my  process,  I 
found  I  liad  a  fillinp,'  baked  in  a  iiiohl  niucli  harder  than  my 
porcelain,  and  Jiow  to  remove  it  safely  was  a  prohlem.  The 
thought  of  adding  a  separating  medium  occurred  first,  and  I  be- 
gan l)y  first  coating  my  mold  with  amorphous  graphite,  chalk 
and  finally  Higgin's  India  ink.  I  very  soon  found  the  carbon  in 
this  ink  burning  up  in  the  great  heat  of  my  furnace.  To  jDre- 
vent  this  1  introduced  a  jet  of  carbonic  acid  gas,  and  later 
liydrogen,  into  my  furnace  through  a  tube,  driving  the  oxygen 
out  of  my  muffle,  in  an  effort  to  prevent  the  oxidation  of  my 
carbon.  This  process  did  not  work  well,  and  I  found  my  inlays 
turning  green,  which  caused  me  to  susj^ect  traces  of  cobalt  or 
copper,  and  not  finding  any  in  the  matrix,  I  concluded  that  the 
copper  was  in  the  India  ink;  so  I  set  that  process  aside  and  took 
up  the  subject  of  a  possible  acid  solvent.  Hydrofluoric  acid, 
with  which  I  had  been  working,  naturally  suggested  itself,  and 
into  this  I  threw  my  inlay.  In  a  few  hours  I  discovered  that 
I  had  etched  my  inlay,  but  apparently  had  joroduced  little  or 
no  impression  on  the  mold.  I  then  heated  the  hydrofluoric  acid 
and  was  delighted  to  see  a  softening  of  the  outer  surface  of 
the  mold.  I  left  it  overnight,  and  the  next  morning  had  the 
pleasure  of  seeing  a  trace  of  my  fast-disappearing  inlay  and  a 
small  portion  of  my  mold.  I  rescued  what  was  left,  washed 
it  in  clear  water,  and  found  that  the  acid  has  effected  a  dissolu- 
tion of  my  mold.  After  finishing  the  next  inlay  I  carefully 
coated  the  exposed  surface  with  melted  wax.  This  I  similarly 
melted  in  cold  hydrofluoric  acid,  and  then  I  succeeded  in  dis- 
integrating my  mold,  having  saved  the  glazed  surface  from  de- 
struction by  coating.  The  inside  of  iny  inlay,  which  had  no  wax 
or  gutta  protection,  was  eaten  up  l)y  the  acid  which  had  been 
absorbed  through  the  matrix  material.  This  caused  me  to  give 
up  hydroHuoric  acid  for  this  purpose. 

"I  next  tried  a  mixture  of  equal  parts  of  nitric  and  muri- 
atic acids.  Again  covering  the  glazed  surface  of  my  inlay  with 
gutta,  1  iiiiiiiersed  it  in  this  solution  and  gradually  disintegrated 
the  mold.  The  time  consumed  was  four  hours,  and  many  un- 
pleasant odors  filled  my  office  and  bhickened  all  the  metal  in  it. 


THE    rollCELAlX     IXLAV  •)')< 

Finally,  after  many  trials,  T  found  the  acid  that  ^vould  dis- 
inte<>rate  my  mold.  I  found  tliat  a  solution  of  one  part  hydro- 
chloric acid  to  four  of  water  is  exceedingly  effective,  cheaper, 
simpler,  and  less  dangerous  than  any  of  the  others.  We  now 
])lace  the  inlay,  coated  witli  wax  or  gutta,  in  a  bottle  of  cold 
dilute  hydrochloric  acid,  leaving  it  when  possible  over  night, 
if  you  are  i)ressed  for  time,  the  separating  process  can  l)e  has- 
teiK  (1  by  heating,  which  will  cause  disintegration  of  the  mohl 
in  a  short  time.  A  chimney  should  be  used  to  carry  off  the 
fnmes.  Even  Avith  this  weak  solution  of  hydrochloric  acid,  it 
is  imi)ortant  that  the  inlay  be  covered  with  melted  wax  or  the 
gutta  solution  before  innnersing  it,  otherwise  it  will  be  found 
that  this  weak  solution  has  acted  on  the  porcelain  and  desti'oyed 
its  luster.* 

"The  inlay  is  now  cleaned  with  small  l)urrs,  and  brushes 
dipped  in  a  solution  of  Bonsit  to  remove  any  trace  of  foreign 
material  from  its  surface.    The  inlay  is  now  ready  to  set." 

The  process  of  casting  porcelain  in  a  vacuum  machine  was 
successfully  accomplished  by  Dr.  F.  S.  AVelden.  In  this  process, 
the  restoration  is  lirst  made  in  wax,  just  as  in  the  cast  gold 
inlay;  this  wax  inlay  is  then  invested  in  a  clear  white  refractory 
compound,  the  wax  is  burned  out  and  the  porcelain  fused  in 
the  crucible  of  the  flask;  when  the  mass  is  liquid,  the  valve  is 
opened  and  the  porcelain  is  sucked  into  the  mold.  It  is  ad- 
visable to  keep  playing  the  flame  upon  the  soft  mass  to  better 
fill  the  entire  mold.  The  process  never  became  popular  and  is 
now  i3ractically  obsolete.  Further  elaboration  of  this  method 
may  be  found  in  September,  1911,  issue  of  the  Dental  Items  of 
Interest. 

Dr.  Stanly  Towie,  of  Fall  Eiver,  Mass.,  takes  an  impression 
of  the  cavity  for  which  he  is  to  make  a  porcelain.  He  varnishes 
this  impression  and  then  runs  a  model  in  inlay  wax.  He  next 
suspends  this  model  in  hydrochloric  acid  (it  seems  to  the  author 
that  hydrofluoric  acid  should  be  used)  and  dissolves  the  cement. 
The  wax  model  is  now  cast  in  pure  gold.  He  thus  gets  a  re- 
production of  the  cavity  in  pure  gold  in  which  he  now  bakes 
his  inlav. 


*I  can  not  conceive  any  advantage  in  casting  the  inlay  witli  wax  or  a  solution 
of  gutta  if  we  are  going  to  subject  the  acid  medium  to  heat. 


358  CAST    (!()LD    AXl)    POllCEl.AlX    IXLAYS 

Tlioiv  are  some  a(lvaiita<;es  and  mmierous  disadvantages  in 
this  method.  Idie  advantages  are  the  j^erfect  unswaged  matrix, 
tlie  practically  obliterated  cement  line,  the  ease  with  which  the 
matrix  may  be  handled  withont  distorting  it,  and  the  conven- 
ience of  tlie  patient. 

The  disadvantages  may  he  enumerated  as  follows: 

The  frec{uent  checking  of  the  porcelain  whicli  comes  from 
the  ditt'erent  coefficient  of  expansion  and  contraction  existing 
between  gold  and  ])orcelain. 

The  difficulty  of  seating  the  inlay  when  completed,  whicli 
may  l)e  obviated  by  grinding  that  jjart  of  the  inlay  whicli  enters 
the  cavity  first,  but  Avhich  at  hest  is  an  empirical  procedure. 
The  necessity  for  chemically  removing  the  matrix,  which  proc- 
ess consumes  a  great  deal  of  time  and  involves  the  handlmg 
of  powerful  acids,  the  fumes  of  which  are  very  unpleasant,  and 
hnally  that  the  method  entails  a  sacrifice  of  time  which  is  not 
justified,  at  least  in  my  opinion,  hy  the  results  ol)tained,  the 
latter  not  heing  sufficiently  superior  to  those  ohtained  by  the 
use  of  a  very  thin  matrix  material  such  as  1/2,500  foil  of  plat- 
inum. 

For  further  and  more  comprehensive  elucidation  of  the 
porcelain  prol^lems  that  the  practitioner  may  have  to  face,  I 
am  pleased  to  refer  to  Byram's  "Principles  and  Practice  of 
Filling  Teeth  with  Porcelain,"  adding  only  my  own  chapter  on 
the  coloring  prol)lem  of  this  phase  of  our  work. 


ciiArrKii  xxji 

EX1)()C'1UX()]X)NT1A,  OR  THE  DlK^rLESS  GLAXDS— 
TUKWl  EXPIJESSIOX   IX  THE  IITMAX  AIOETII 

Tliore  are  many  ])L'()])1('  who  are  perl'eetly  well;  their  daily 
life  is  often  one  of  intense  })liysieal  and  mental  activity,  and  yet 
tliey  rarely,  if  ever,  require  therapeutics  or  mechanical  atten- 
tion. There  are  others  who  are  miserably  ill,  mentally  and  ])liys- 
.ically,  tluMr  daily  life  is  one  of  continued  attemi)t  to  ^iiai-d 
against  further  encroachmtnt  by  disease.  They  are  continually 
under  the  care  of  some  one  ministering-  to  some  of  their  ailments 
successfully  or  otherwise.  Some  people  for  a  period  of  time  are 
perfectly  well,  then,  for  some  obscure,  and  to  most  observers, 
unaccountable,  reason,  sicken  or  fall  seriously  ill,  to  recover  in 
the  same  obscure  and  unaccountable  manner  and  continue  to 
live  and  to  work  without  furthei-  interference  from  disease,  for 
theii-  allotted  numbers  of  years. 

in  corollary  with  the  al)ove,  there  are  many  people  whose 
dental  apparatus  is  in  perfect  balance,  mechanically  expressed, 
in  perfect  occlusion,  who  never  recpiire  any  (h^utal  interference; 
still  others  whose  teeth  were  in  imperfect  condition,  as  expressed 
in  nudocclusion,  have  had  them  jDlaced  in  balance,  and  subse- 
quently require  an  incessant  amount  of  dental  interference  to 
keep  on  repairing  and  replacing  jKirts  of  the  continually  break- 
ing down  apparatus.  Some  people  never  jDay  any  attention  to 
the  cleanliness  or  the  environment  of  their  teeth,  and  yet  they 
never  need  to,  nor  do  they  seek  dental  interference  for  the  alle- 
viation of  any  dental  disorder.  There  are  others  who  are  con- 
stantly having  their  teeth  cleaned,  their  roots  scraped  and  their 
gums  scoured,  and  still  their  teeth  continue  to  ])resent  new  cavi- 
ties, new  breakdowns,  new  dystroj^hies. 

Manifestly,  the  correction  of  bodil_\-  health  and  toolli  health 
is  not  clearly  understood. 

^[any  physicians,  numy  surgeons,  many  dentists  will  readily 

359 


360  CAST    COLD    AXD    PORCELAIX    IXLAYS 

admit  the  truth  of  the  fore^'oino-  and  attest  to  the  statement  tliat 
tliey  are  and  have  been  constantly  on  tlic  alci't  for  some  thing, 
some  truth,  tlie  understanding  of  wliich  woukl  enable  them  to 
more  effectively  handle  and  efface  bodily  disorders. 

]\iay  it  not  justly  be  said,  right  here,  that  the  cause  of  med- 
ical and  dental  ineffective  ministrations  has  been  due  to  the 
classification  of  cases  of  patients  in  the  aggregate  under  the 
heading  of  certain  diseases,  when  we  should  have  devoted  our 
attention  to  the  close  study  of  the  individual  constitution  of 
each  patient,  and  so  learn  to  treat  an  aggregate  malady  in  an 
individualized  way. 

It  is  a  fact  that  the  same  disease  will  express  itself  differ- 
ently in  different  individuals,  and  yet,  if  we  take  np  our  works 
on  therapeutics,  we  shall  find  a  woeful  lack  of  individualization 
of  cases  calling  for  treatment. 

Under  the  heading  of  "Pneumonia,"  the  pneumonia  is 
treated,  under  the  heading  of  "Diphtheria,"  antitoxin  is  advo- 
cated. Tuberculosis  has  its  prescribed  order  of  treatment,  etc. 
Tt  is  always  the  disease,  almost  never  the  patient. 

AVe  have  become  so  ol)sessed  with  the  pathologic  anatomy 
of  the  case  that  we  fail  to  recognize  the  ever  receding  voice  of 
God  in  the  individual,  struggling  with  all  the  normal  that  is  in 
him,  to  overcome  the  very  joicture  we  take  as  a  guide  to  our 
treatment.  It  is  so  in  dentistry,  we  see  the  teeth  of  children 
decay,  and  we  either  remove  the  teeth  and  disturb  the  arch ;  or 
we  fill  the  teeth  which  have  decayed,  and  allow  the  child  to  go 
with  the  predisposition  to  decay  in  the  constitution,  unrestricted 
to  work  its  further  havoc. 

AVe  see  a  case  of  so-called  ti'aumatic  occlusion  and  we  begin 
to  file  and  grind  the  teeth  into  iiioi-e  or  less  acceptable  stress 
relationsliip,  pa\ing  no  attciiiioii  to  the  ])articular  "ism"  in 
that  particulai-  constitution  which  caused  the  arrangement  of 
teeth  ultimately  bi-inging  about  the  traumaism  that  sent  the 
patient  to  us  in  seaich  foi-  relief. 

A  woman  becomes  ])i-egnaii1,  beai's  and  gives  birth  to  a 
child,  many  of  her  teeth  begin  to  decay,  she  loses  one  or  two  of 
them,  dui'ing  the  period  of  lactation,  she  seeks  our  advice  and 
hel]),  and  we  dentists,  i)i  almost  evei-y  instance,  fill  the  decayed 


EXDOCIMXOLHjNTlA  361 

t(H'tIi  and  rt'j)lace  the  lost  oiios  and  dismiss  lici-  to  fto  tlirou^li  the 
same  dental  ordeal,  should  she  l)e  called  upon,  in  her  relation  as 
a  wife,  to  again  become  procreatively  active. 

A  case  of  pyorrliea  presenting  for  relief,  tlie  patient  is  either 
pyroeided,  vaccinated,  scaled,  scraped,  scalded,  rubbed  and 
drugged  locally,  a  few  teeth  are  lost,  being  too  far  gone;  a  few 
are  filled,  not  far  enough  gone;  a  few  are  crowned  with  golden 
caskets  and  the  bill  paid,  the  patient  is  allowed  to  go  and  take 
the  pyorrheal  potential  in  his  or  her  constitution,  the  attack 
recurs  with  renewed  virulence  and  renewed  destruction. 

Time  to  change  about  it  seems  to  me,  time  to  realize  that  we 
have  not  been  dealing  with  the  fundamental  facts  of  the  cases  in 
our  treatment  of  diseases. 

All  the  bacteriology  we  know  has  not  enabled  us  to  eliminate 
effectively  diseases  the  bacteria  of  which  we  know  best  and  are 
most  familiar  with. 

Time  to  realize  and  to  profit  from  tliis  realization  that  there 
are,  for  example,  any  number  of  individuals  to  whom  we  could 
feed  sandwiches  made  up  of  bread  and  pneumoeocci  and  who 
would  be  none  the  worse  for  the  diet.  This  is  equally  true  of 
all  germs,  not  excepting  the  most  virulent  of  streptococci. 

Some  people's  teeth  will  not  decay  in  spite  of  the  lack  of 
any  attention  on  their  j^art  or  the  dentist's  part. 

Some  people  need  but  the  least  exposure  to  contract  all  sorts 
of  diseases.  Some  j^eople's  teeth  decay  in  spite  of  all  attention. 
Some  children  never  have  any  infectious  diseases,  some  have  all 
sorts  of  afflictions. 

AVonderful  resistance  in  the  apparently  immune  specimens, 
lowered  resistance  in  the  others.  Yes,  my  friends,  but  what  is 
this  resistance !  AVhy  are  some  possessed  of  it  and  wliy  not  the 
others  f  AVhei-e  do  they  who  have  it  get  it,  and  what  do  those 
who  suffer  lack,  in  order  to  make  it? 

Patients  have  become  habituated  to  seek  a  physician  so  he 
may  see  the  disease.  Physicians  should  become  liabituated  so 
that  when  they  look  at  and  for  a  disease  they  should  see  the 
patient. 

Patients  have  become  habituated  to  go  to  the  dentist  so  he 
may  look  at  and  after  the  teeth. 


oG2  CAST    t;OLn    AND    PORCELAIN    IXI.AYS 

Dentists  slioiikl  ])ec'oino  lial)ituated  so  tliat  wlionever  they 
look  at  a  tooth  (kn-ayed  or  liealthy,  they  shoukl  see  the  patient. 

All  this  does  not  mean  revolution,  neither  does  it  mean  a 
reactionary  j^rogram,  it  simply  means  a  broadening  of  our 
vision,  a  more  comjorehensive  understanding,  and  hence  a  more 
effective  service  in  onr  field  of  endeavor. 

The  endocrines  are  the  organs  of  inteiiial  secretion. 

Endocrinology  is  the  study  of  the  organs  of  internal  secre- 
tions and  the  study  of  the  functions  of  these  organs. 

Secretion  is  a  specialized  function  of  certain  glands  made 
up  of  highly  specialized  epithelial  cells  (secreting  cells)  in  the 
exercise  of  which  function,  they  take  up  substances  from  the 
blood  stream  and  elaborate  these  substances  into  products 
wholly  at  variance  in  aiDpearance  and  effect  with  the  substances 
which  were  taken  u]),  and  discharge  these  products  l)y  the 
avenue  of  special  channels  or  ducts  into  various  organs  of  the 
vegetable,  animal,  or  human  economy,  to  effect  the  jjliysiologic 
expression  of  these  organs. 

Internal  secretion  may  be  defined  in  the  same  terms,  except 
that  there  are  no  special  channels  or  ducts  through  which  the 
products  elaborated  by  the  ductless  glands  are  conveyed  to  the 
various  organs;  so  that  these  products  may  be  said  to  find  their 
way  into  the  various  parts  of  the  body  by  dii-ectly  entering  the 
1)1  ood  stream. 

The  products  of  the  ductless  glands  or  glands  of  internal 
secretion  have  been  termed  hormones  from  the  Creek  word,  to 
excite. 

Tlieir  iiiduciicc  upon  the  functions  of  the  various  organs  of 
tlic  hody  is  one  of  augnieiitation  or  excitation  and,  uinkM-  some 
cii'cunistances,  one  of  iiiliibilioii. 

The  potency  of  these  prtxhicts  is  prad  icallx'  in(h'])en(h'id  of 
(puuititx"  and  wholly  inlcnlcixMidcid  a>  to  (pialitv.  in  this  re- 
spect, the>'  ai'c  \cr\'  much  akin,  if  nol  wliollx'  like  enzymes  or 
fei-ments. 

Tliey  ai'c  in  such  a  fine  slal<'  of  sul)di\ision  Hint  lliey  uia\' 
be  liixcned  to  eh'cl  ronlomic  mcsscngci's  comnniuicat ing  and 
cai'rying  oi'(h'i"s  or  dircflions  or  aid  from  llic  \'egetative  centers 
to  all  parts  of  tlu,'  body  willi  which  Ihc}'  communicate  at  all. 


KX]i()C'i;i.\()I)()XTIA  o()o 

T]\('  iiiosi  iiiipoi'taiit  (hictlcss  (glands  as  we  know  tlioiii  arc, 
lirst  llic  ])iii('al,  a  small  ,<;laii(l  siiuati'd  at  tJic  base  ol'  the  ])itiutary 
body. 

Second,  the  piluitai-y  body,  a  vei-y  vascuhir  <;land,  consist- 
ing- of  an  ant(M-ioi-,  middle  and  j)ost<'i-ioi'  ])ortion,  all  sitiiat(Ml  in 
the  sella  turcica  of  the  sphenoid  bone.  It  ft'overiis  periodicity, 
I'hythm,  inlluences  i;rowt]i,  nutrition,  rei)roductioii,  the  psy- 
chosis, and  is  influenced  by  the  thymus,  the  thyi'oid,  the  <;-onads, 
and  the  adrenals. 

Third,  the  thyroid  ,<;iand  and  the  ])arathyroid  Ijodies.  The 
first  consists  of  two  lateral  lobes,  disjjosed  on  either  side  and  in 
front  of  the  larynx  and  ui:)per  three  or  four  rings  of  the  trachea. 
The  parathyroid  bodies  are  arranged  on  either  side  of  the  me- 
dian line  and  niav  he  found  as  low  as  the  seventh  tracheal  ring. 
The  thyroid  is  a  very  vascular  hody  of  gland  tissue,  it  is  sup- 
plied l)y  the  su])erior  and  inferior  thyroidal  arteries,  which  form 
a  rich  anastomosis.  The  veins  are  correspondingly  free  and 
numerous,  they  are  valveless  and  empty  into  the  jugular  and 
innominate  veins.  It  inHuences  nutrition,  growth,  rej^roduction 
and  is  profoundly  influenced  l)y  functional  and  organic  disturh- 
ances  of  the  alimentary  canal  and  the  gonads. 

Fourth,  the  thymus  develops  as  a  paired  sac-like  divertic- 
ulum of  the  ventral  ])ortion  of  the  third  and  fourth  and  possibly 
the  second  pharyngeal  cleft.  This  sac-like  heginning  of  the  thy- 
mus is  entirely  epithelial  in  structure.  It  influences  metabolism 
in  the  child,  also  the  thyroid,  the  pituitary  and  the  gonads,  and 
is  itself  markedly  affected  l)y  pituitary  and  adrenal  disturhances. 

Fifth,  the  su])rarenal  capsules,  adrenal  hodies,  are  two 
small,  flattened,  glandular  bodies  located  in  the  l)ack  part  of  the 
al)domen,  above  and  somewhat  anteriorly  to  the  u])per  part  of 
each  kidney.  They  consist  of  a  cortical  and  medullary  portion, 
they  are  exceedingly  vascular,  with  abundant  lymph  supj^ly. 
The  nerve  supply  is  significant,  l)eing  derived  from  the  solar  and 
renal  plexuses  and  getting  branches  from  the  phrenic  and  j^nen- 
mogastric  nerves.  Their  im])ortant  connection  with  the  sympa- 
thetic is  today  well  known.  Dr.  Jose])!!  Fraenkel  terms  the 
symjiathetic  nerve  "the  frozen  adrenal"  attempting  to  convey 
the  im])ression  that  it  is  a  continuous  line,  icicle  as  it  were,  of 


3G-J:  CAST    CJOLD    AND    POllCELAlX    l^^LAYS 

j)n)j('cU'(l  adii'iml  substanco.  Tlie  adrenals  play  a  most  imj)ort- 
aiit  ])art  in  the  development  of  the  being;  a  tremendous  part  in 
the  mental  growth  of  the  being.  Virtnally,  the  great  center  of 
the  autonomic  nervous  system,  they  have  been  called  the  abdom- 
inal brain,  they  control  energy  and  the  decorative  scheme  in  the 
body;  tliey  lia\e  everything  to  do  with  pigmentation,  with  oxy- 
genation of  the  blood;  they  influence  the  thymus,  the  thja-oid,  the 
pituitai-y  body  and  the  sexual  organs,  and  are  themselves  mark- 
edly affected  by  thyroidal,  pituitary,  and  gonadial  influences. 

Sixth,  the  gonads,  the  organs  of  immortality  on  the  pro- 
creative  i^lane  or  better,  the  instruments  whereby  man  perpetu- 
ates his  species  on  earth.  In  children  the  gonads  are  markedly 
influenced  by  the  thynuis,  the  persistency  of  which  will  retard 
adolescence.  In  children  of  normal  development,  the  thymus 
goes  out  at  puberty  and  the  thyroid  Avith  its  regulating  and 
supervising  influence  comes  in.  At  that  time  also,  the  assertive 
])eriod  of  tiie  gonads  becoming  manifest,  they  call  on  the  adren- 
als in  the  male  and  on  the  pituitary  in  the  female  to  set  up  an 
intercommunicating  system  of  harmonic  relations,  which  result 
in  a  most  intimate  interdependence,  very  apparent  in  the  female 
during  menstruation,  pregnancy,  childbirth,  and  lactation,  in 
tlie  male  during  periods  of  great  physical  stress,  excitation  or 
copulation  or  of  sublimation  of  the  j^rocreative  urge  into  intel- 
lectual or  intuitional  poetic  expression,  in  other  words  during 
inversion  of  procreation  to  creation. 

The  foregoing  may  be  summed  up  rather  crudely  as  follows: 

Th  y  1 1 1  us — Youth. 

Thyi'oid — Quality  and  equilibrium. 

I^ituitary — Bulk  and  disposition  (psychosis). 

Adrenal — Energy  and  decoration. 

(lonads — Immortality  or  ])rocreation. 

Pineal — Intelligence,  soul  oi-  cosmic  relationship  (?). 

Tlie  normal,  augmented  or  inhibited  activity  of  one  or  more 
oi-  iiU  of  these  glands  is  manifested  in  diverse  ways  in  the  human, 
dental  apparatus,  and  it  is  to  the  recognition  and  the  study  of 
tliesc  inanircstations,  that  I  lia\-('  given  Hie  name  of  Endocrino- 
dontia. 

The  thymol  rop,  the  1ii>i-()1  roj),  the  pil  uilolrop,  the  adi'eno- 


E  X I )()('  I ;  I  x  ()  I )( )  x  T I A  365 

trop  and  llic  ^'onadolroj)  arc  iiaiiics  or  dcsLguatioiis  apiicnded  to 
individuals  who  exliihit  in  tlu'ir  makeup,  a  preponderance  of 
thymic,  lliyroidal,  ])itiiilary,  adiciial,  oi'  ft'onadial  influences,  as 
the  case  may  be. 

Dr.  D.  M.  Kaphui,  the  director  of  tlic  lal)oratories  at  the 
Neurological  Institute  of  New  York,  ])ul)lislic(l  an  article  in 
Endocrinologii,  April,  lf)17.  lie  called  this  ai'ticlc  '^An  Endo- 
crine Interpretation  of  the  Dental  Ajjparatus." 

The  quotation  of  tiiis  article  in  full  will  l)e  illuminating-, 
particularly  since  I  wish  to  j^oint  out  what  appear  to  me  to  ]je 
some  slight  errors  in  his  conception  and  nomenclature. 


^' There  is  not  the  least  doubt  that  the  glands  producing 
internal  secretions  exert  an  influence  upon  the  exterior  of  the 
individual.  Although  the  uninitiated  still  may  consider  cer- 
tain individual  peculiarites  as  accidental,  the  endocrinologist 
knows  which  organ,  or  organs,  were  instrumental  in  the  produc- 
tion of  these  seemingly  accidental  phenomena.  To  ascri])e  a 
certain  bodily  appearance  to  accident  is  a  confession  of  igno- 
rance, which,  however,  is  becoming  less  frequent  the  more  one 
studies  the  mystic  forces  of  the  endocrines.  The  study  of  their 
functions  can  not  be  severed  from  the  study  of  these  glands,  so 
much  so,  that  one  may  justly  call  this  specialty  an  investigation 
of  the  'compensatory  dynamics  of  the  endocrines  in  health  and 
disease.' 

"To  understand  the  compensatory  workings  of  the  endo- 
crines is  to  know  'internal  secretions';  and  to  be  able  to  trans- 
late it  into  terms  of  physiology  and  pathology  is  to  know  how 
to  handle  your  patient  from  an  endocrine  point  of  view.  There 
are  many  external  manifestations  resulting  from  the  work  of  the 
endocrines  that  have  been  carefully  studied,  many  that  are  only 
superficially  known,  and  still  more  to  be  discovered  in  the 
future.  To  the  endocrinologist  a  pigmented  mole  is  not  an  acci- 
dent, nor  the  nmstached  female  of  twenty-five,  nor  the  soft  pulse 
at  eighty,  nor  the  high  blood  pressure  at  thirty,  nor  the  enlarged, 
noninfected  tonsil.  It  is  the  why  and  wherefore  of  a  peculiarity 
that  is  tlie  constant  question  l)efore  the   endocrinologist,  and 


3()G  CAST    c:()Ll)    AXD    roiU'KLAIX     IXr.AVS 

V(.'ry  often  tlir  answer  is  ratlieally  o])i)()se(l  to  ortliodox  allopatliie 
tliouglit.  Tlierefore  the  uninitiated  may  l)e  perplexed  by  the 
stand  taken  by  tlie  student  of  compensatory  dynamics,  who 
ari;nes  against  tlie  reduction  of  a  liigh  l)lood  pressure  in  a  cer- 
tain patient,  or  the  removal  of  the  tonsils  in  another,  and  yet  he 
may  offer  very  sound  reasons  for  both  conclusions. 

''In  Ills  endeavor  to  arrive  at  the  truth,  tlie  student  of  'com- 
pensatory dynamics'  takes  into  consideration  the  fact  that  cer- 
tain infections  have  an  affinity  or,  as  I  have  designated  it,  a 
'tropisnr  for  certain  glands  with  internal  secretion.  For  in- 
stance, it  is  known  to  all  that  munii^s  is  an  infectious  disease 
that  often  attacks  the  gonads.  It  has  been  noted  that  diphtheria 
and  typhoid  have  a  tendency  to  crij)ple  the  adrenals,  so  that 
mumps  is  known  as  a  gonadotropic  infectious  disease,  while 
diphtheria  is  an  adrenotropic. 

''There  is  also  a  definite  tropism  between  endocrine  disturb- 
ances and  the  dental  apparatus.  Ewan  Waller,  of  Birmingham, 
England,  has  very  definitely  associated  the  teeth  in  children 
with  the  thyroid  function.  It  seems  that  the  glands  with  inter- 
nal secretions  play  an  important  role  not  only  in  the  structural, 
but  also  in  the  physiochemical  economy  of  the  individual.  A 
great  number  of  the  unclassified  subjective  disturbances  for- 
merly designated  as  neurasthenia,  neurosis,  or  hysteria,  and 
lately  as  vagotonia,  can  be  more  justly  ascribed  to  an  aberration 
or  a  disturbance  in  the  compensatory  dynamics  of  the  endo- 
crines.  The  thorough  investigator  of  the  constitution  of  an 
individual  in  health  or  disease  takes  into  account  the  j^henomena 
not  only  as  pictured  in  our  l)ooks  on  diagnosis,  l)ut  also  the  time 
of  day  or  night,  the  amelioration  or  intensification  of  symptoms 
in  the  evening,  its  involvement  of  the  right  or  left  side  of  the 
body  and  1h'  (linVi-ciitiatcs  where  the  same  complaint  a])pears  in 
the  juvenile,  adult,  or  senile  individual. 

"There  are  a  great  many  points  dismissed  l)y  the  uninitiated 
as  insignificant,  which  the  endocrinologist  employs  to  advantage 
ill  liiiilding  up  a  picture  oF  (llslurhcd  ('<|iillll)rliiiii  in  a  ])atient. 
The  jK'Culiarilies  of  the  dental  a])])ai'atus  is  one  of  them. 

"TffviJODONTiA. — It  is  a  faii'ly  well-established  fact  that 
the  calcium  metal)olism  is  goveiiKMJ  chielly  by  the  thyroid  ap- 


KXDOCKI  XoDO.VriA  ,')()7 

l)arcitiis,  and  sccondaiily,  hy  the  i-csl  ol'  llic  ciKloci-iiics.  The 
alkaliiiily  of  tlic  salixa  to  a  cciiaiii  cxlciil  dcix-nds  ii|)()ii  calciiiin 
salts.  It  is  to  !)('  seen  liow  a  dist  iii-hcd  ciidoci-iiic  ('(juilihi'iuiii 
could  ))i-iii^'  al)out  dental  <l('ca>'  l)\'  a  distui-bancc  in  tli(»  calciiiiii 
iiietabolisiii  halaiicc,  ])art iculai'ly  in  childi-cn  \vli()  dcjK'nd  ii])on 
their  tlixi'oid  and  thymus  more  than  the  adult  and  senile.  The 
calciuiu  bein^'  delieienl,  tlie  acids  from  food  docoiuposition  aro 
not  neutralized,  and  the  dentine  consequently  suffei's,  this  hein;;- 
one  of  the  stafi,'es  in  the  coni])lete  ])r(.akin;^'  down  of  the  tooth.  In 
children  ])articulai'ly,  a  \vell-l>alaiiced  thyroid  and  sound  teeth 
fto  together,  if  the  thyi'oid  is  not  perforin ing  its  duties  ])rop- 
erly,  the  tooth  to  suffei-  fii-st  is  the  iiiolar.  The  suhniaxillary 
saliva  is  said  to  he  richer  in  calcium  than  the  parotid,  and  in 
view  of  the  fact  that  the  molai's  lie  Ixdiind  the  duct,  their  sui)i)ly 
of  innnunizing  saliva  is  less  than  the  fi-ont  teeth,  and  hence,  in 
case  of  calcium  deficiency,  they  succumb  first.  This  is  mani- 
festly apparent  in  the  longer  life  of  the  lower  front  teeth  as 
compared  with  the  u])i)er,  the  latter  not  having  the  constant 
salivary  l)atli  enjoyed  by  the  lower  teeth.  This  is  very  charac- 
teristically disi)layed  by  the  woman  with  an  exhausted  thyroid, 
due  to  repeated  ])regnancies,  who  invariably  loses  her  upper 
incisors.  Of  course  in  such  women  the  other  endocrines  enter 
into  the  mechanism  conducive  to  dental  loss. 

"To  start  with,  thyroid  teeth  are  distinguished  by  their 
slender  frame,  they  are  thinner,  more  transparent,  and  graceful, 
and  their  color  tends  toward  a  bluish  gray  Avhite.  Children  and 
married  women  with  such  teeth  can  be  saved  a  great  deal  of 
dental  trouble  by  the  discreet  and  timely  administration  of 
thyroid  extract.  The  frecpiency  of  the  therapeutic  display  de- 
pends entirely  u])on  the  case  and  the  acumen  of  the  physician. 

"In  the  multi])ara  the  dental  situation  from  an  endocrine 
point  of  view  is  only  partly  thyroidal.  The  interj^lay  and  com- 
pensatory work  of  all  of  them  are  necessary  to  help  her  through 
this  physiologic  symbiosis.  If  the  woman  is  deficient  in  any  of 
the  endocrines,  she  will  display  not  only  dental  changes,  l)ut  all 
kinds  of  other  objective  and  subjective  manifestations  depend- 
ing upon  the  glands  or  gland  involved.  The  falling  out  of  the 
upper  incisors  independent  of  decay,  l)ears  a  distinct  jDituitary 
stamp,  and  one  may  say  that  the  maxillaiy  sockets  become  too 


368  CAST    GOLD    AND    PORCELAIN    INLAYS 

large  in  some  pregnant  women,  and  that  the  root  is  not  firmly 
implanted  in  such  a  jaw,  at  this  episode  of  partial  transient 
jjhysiologic  acromegaly.  It  is  the  duty  of  the  discerning  jjhysi- 
cian,  as  well  as  the  dentist,  to  guard  against  irreparable  loss, 
disfigurement  and  suffering  of  patients  by  a  timely  use  of  thy- 
roid extract  in  cases  of  dental  caries  or  late  eruption,  as  well  as 
in  gestations  that  ju'omise  injury  to  the  teeth. 

' '  PiTUiTODONTiA. — Many  individuals  who  are  free  from 
complaints  that  would  compel  them  to  seek  a  jDh^^sician 's  advice, 
are  the  possessors  of  teeth  characteristic  of  the  acromegalic. 
The  owners  of  such  teeth  need  not  develop  acromegaly,  never- 
theless they  must  be  regarded  as  potentially  pituitary.  Chronic 
frontal  headaches  and  the  slightest  limitation  in  the  temporal 
visual  fields,  require  very  earnest  attention  and  extremely  judi- 
cious endocrine  therapy,  for  at  such  a  stage  one  might  hold  out 
some  hope  of  deferring  the  advent  of  the  full-fledged  acromegalic 
picture.  Increase  in  size  of  the  acral  parts  is  the  chief  objective 
sign  of  this  disease  and  the  pituitary  is  the  gland  responsible  for 
its  appearance. 

"It  must  not  be  forgotten,  however,  that  not  only  an  in- 
crease, but  also  a  very  marked  diminution  in  size,  belong  to  the 
activity  of  the  pituitary  gland;  so  that  giant  and  pigmy  are 
endocrinologically  related.  The  same  applies  to  the  teeth.  The 
average  pituitary  dental  arrangement  shows  large  square  teeth ; 
oftener  than  not  the  upper  middle  incisors  are  spaced  (trema) 
and  the  rest  of  tlie  teeth  may  share  in  their  separation,  stopping 
at  the  bicuspids.  On  the  other  hand,  marked  overcrowding  is 
a  feature  wdiich  also  belongs  to  the  department  of  hypophysial 
activity,  so  that  one  is  fi-equently  confronted  with  a  situation 
j(M|uiiing  gerat  care  in  endocrine  interpretation.  The  gestating 
female  has  been  referred  to  before,  ])ut  it  must  be  reiterated, 
that  the  falling  out  of  the  incisors,  particularly  the  lateral  one, 
lias  a  double  meaning.  At  present  let  us  not  forget  that  the 
middle  upper  incisors  are  preeminently  the  teeth  closely  asso- 
ciated with  direct  j)rimary  pituitary  function.  This  does  not 
signify  tiiat  the  individual  has  a  pituitary  aljiiormality  incom- 
pati))l(!  with  perfect  liealth;  it  may  show  itself  in  anyl)ody  witli 


EXDOCRIXODOXTIA  369 

acceptocl  ]iy})0})]iysial  iiiarkin<;s,  sucli  as  l)eiii<>'  very  tall  or  very 
short,  liaviii<;-  a  very  lai'^e  liead,  ])ai'ti('iilarly  in  tlie  frontal  part, 
oi"  iiiaiiifestiii^-  a  tendency  to  adiposity  in  tlie  yonn<;'  or  adult, 
with  or  without  hyj)o^enitalisni.  It  may  aeeonipany  the  fem- 
inine type  of  man  who  shows  his  abnormality  in  his  teeth  only, 
and  his  sexual  anomaly  in  his  psyejioanaiysis. 

"(lOXAUonoxTiA. — Individuals  with  a  ,i;'()nadoti'()j)ism  may 
^ive  in  tlieii'  liistoi'y  an  attack  of  nuimi)s  during-  ciiiklhood. 
Close  relationshij)  between  this  contagious  disease  and  the  gen- 
ital glands  is  established  by  the  frequent  involvement  of  the 
ovary  or  testis  in  a  comj^licating  inllannnatory  reaction.  It  is 
not  necessary  that  the  individual  previously  having  had  nmmps 
should  present  earmarks  of  a  definite  gonad  disease,  he  may  yet 
show  them  in  the  future  or  not  at  all.  This  depends  entirely 
ui)on  the  compensatory  work  of  the  rest  of  the  endocrines. 

''In  all  endocrine  manifestations  not  oidy  the  soma,  but 
also  the  psyche  is  influenced.  Besides  these  psychic  attributes 
most  of  them  show  definite  somatic  stigmata,  of  course  not  all 
of  them,  the  exceptions  here  as  elsewhere  serving  to  establish 
the  rule, 

"In  the  gonadotrojiic  individual  the  dental  apparatus  car- 
ries a  very  striking  earmark  of  the  tropism.  If  the  middle  upj^er 
incisors  carry  a  message  from  the  pituitary,  the  lateral  upper 
incisors  certaiidy  do  the  same  from  the  gonads.  So  that  when 
the  gonads  are  teratologically  ah  ovo  definitely  abnoniial,  one  is 
sure  to  find  some  abnormality  in  the  upi^er  lateral  incisors.  The 
relationship,  if  any,  is  a  crossed  one,  so  that  the  right  ujoper 
lateral  incisor  may  point  to  the  left  testis  or  ovary,  and  vice 
versa. 

"It  is  also  to  be  noted  that  the  greater  the  deviations  from 
normal,  the  more  definite  the  markings  in  the  dental  department, 
so  much  so,  that  the  lateral  incisors,  as  a  result  of  a  marked 
gonad  defect,  may  not  have  eruj^ted  at  all.  Such  a  dental  situa- 
tion is  rare  indeed,  so  is  also  the  clinical  condition  presented  by 
the  patient  who  has  it.  Here  is  a  situation  that  the  gynecologist 
could  profit  by,  and  the  surgeon  add  another  sign  to  the  sig- 
nificance of  right-sided  abdominal  pain.  Such  a  pain  is  usually 
ovarian,  when  the  left  upper  lateral  incisor  is  faultily  implanted. 


370  CAST    GOLD    AND    PORCELAIN    INLAYS 

showing-  the  mesial  edge  of  the  tooth  anteriorly,  and  protruding 
in  front  of  the  middle  incisor.  The  teeth  j^resumed  to  be  con- 
nected with  the  gonads  (upper  lateral  incisors)  carry  the  stamp 
of  ovarian  or  testicular  abnormality  in  their  size,  shape  or  im- 
])lantation. 

"The  ovary  should  always  be  suspected  where  pelvic  pain 
is  manifested  in  a  patient  whose  lateral  incisors  are  abnormal. 
In  the  male,  snuUl  stumjiy  laterals  besj)eak  sexual  impotence  on 
a  i)hysical  ])asis,  many  gonorrheas,  prostatic  insufficiency,  and 
chronic  strictures.  In  such  an  individual  one  may  obtain  the 
history  of  mumj^s,  and  if  he  had  a  rights! ded  orchitis  or  epididy- 
mitis, more  often  than  not  his  left  upi^er  lateral  incisor  will  be 
differing  from  the  normal,  taking  his  entire  dental  apparatus  on 
the  standard  of  comiDarison. 

"On  rare  occasions  the  compensatory  work  of  the  other 
endocrines  is  so  well  adjusted  that  the  dental  anomaly  is  obliter- 
ated, and  gives  no  clue  to  the  existing  gonadopathy.  There  are, 
however,  other  external  signs  from  an  endocrine  point  of  view 
that  would  direct  attention  to  the  existing  state  of  affairs.  As 
the  dental  apparatus  is  the  subject  of  this  paper,  the  other  signs 
will  not  be  discussed. 

"There  is  a  dangerous  tendency  among  endocrinologists  to 
<lesignate  "with  peremptory  precision  that  this  or  that  organ  is 
involved,  and  is  responsible  for  the  endocrine  picture.  Very 
often  the  external  manifestations  are  caused  by  another  gland 
whose  functions  it  may  ))e  to  bring  about  phenomena  on  the  sur- 
face of  the  patient,  such  as,  for  instance,  the  adrenal  system;  and 
some  students  may  be  carried  away  by  this  easily  demonstrable, 
supei'ficial  apjx'aranci^  and  be  led  to  assign  to  the  objective  find- 
ings the  i)la('c  oF  (ii'st  iiiipoi'taiicc;  wiun'eas,  the  adrenals  have 
simply  acted  in  resjionsc  to  a  '-all  From  some  other  gland.  The 
gonads  always  reqiiir*'  adrenal  help  in  j)erforniing  their  work, 
and  when  11i<'>'  do  not  conic  up  1o  llic  pliN'siologic  requirement, 
he  this  in  1lic  Form  oF  under-  or  ovei-activity,  the  adrenals  are 
then  callc(l  upon  For  additional  assistance,  resulting,  secondarily 
only,  in  manifestations  ajipearing  on  the  skin,  mucous  mem- 
])ranes,  haii",  etc.  The  primary,  ah  oro.  situation  can  be  read 
from  the  teeth  and  the  gland  res))onsil)le  For  the  trouble  more 
often  than  not,  can  l)e  uneri'ingly  named  and  proper  therapy  sug- 


KXDOCItlXOItOX'l'IA  .")(  1 

geslecl.  II  is  rciiiai'kahlc  liow  i-cndily  tlic  |)ati('nt  i-csjjoikIs  wlieii 
tho  projxT  (Ivuii;  is  ))r('S('ril)('(l,  hiil  Ik  I'c,  as  clscwlu'i-c,  the  futility 
of  atl('iii])liii,i;'  i-('|)la('('iii('iit  1  licfap)'  in  some  cases  must  ])e 
tliorou^lily  ^auftcd. 

"A  youii^'  woman  sulTe]-iu<i,'  trom  the  torture  i-(  suiting-  iVom 
a  eom])lete  ooi)lioreetomy  ean  not  ))e  ])enelite<i  much  1)y  ovarian 
exti'acts,  ))('  it  tlie  wliole  ^laiid  or  tlic  luteal  poi-tiou.  In  some 
cases  one  nuist  he  able  to  read  intelliiicntly  the  sym])tomatolo^y, 
and  eurh  as  much  as  jjossihle  the  j)ituitary  com])ensation,  for  in 
sucli  cases,  this  is  the  g'land  that  may  be  causing'  much  of  the 
sul)ji'cti\-e  (liscomFort.  if  the  ])ituitary,  however,  is  not  capal)le 
ol"  compensation,  oi-  is  onh'  ])artly  a))le  to  assist,  the  adrenal  and 
thyroid  systtnis  are  employed  to  overcome  the  deticiency.  De- 
pending uj^on  the  fitness  of  these  glands  one  will  have  a  predomi- 
nating adrenal  or  thyi-oid  symptomatology.  Therapeutic  success 
depends  entirely  upon  our  ability  to  recognize  the  vicarious 
execution  of  functions  by  glands  with  a  dilferent  purpose. 

"Adrenodoxtia. — It  is  to  lie  conceded  that  the  al)ility  to 
perform  jjetter  work  recpiires  better  tools.  In  biology  this  is 
everywhere  evident.  From  times  inunemorial  the  longer  and 
sharper  tooth  was  ])art  of  the  outtit  of  the  pithecanthroijus, 
whose  survival  was  assured.  Such  a  specimen  was  perhaps  also 
the  hairiest  of  the  tribe.  As  time  advanced  and  the  necessity  for 
using  the  teeth  in  offensive  and  defensive  existence  became  sec- 
ondary to  the  special  development  of  the  thumb  and  hands,  the 
chief  fighting  teeth,  the  canines,  became  shorter,  aiul  in  some 
very  peaceful  members  of  our  semisimiau  ancestors,  also  less 
sharp.  With  the  greater  use  of  the  hand  came  the  jjerfection 
of  that  part  of  the  brain  that  serves  as  the  storehouse  for  memo- 
ries. These  memories  became  the  heritage  of  the  future  man, 
and  with  the  greater  specialization  of  the  hand,  the  teeth  were 
gradually  discarded  as  weapons  of  defense  and  offense.  The 
emotions  in  the  state  of  offensive  rage  still  cause  the  display 
of  them,  although  one  does  not  use  them. 

"Vasomotor  force  and  the  tone  of  muscles  depends  npon 
the  proj^er  work  of  the  adrenals.  Only  when  these  glands  work 
better  than  the  others,  is  it  possible  to  think  of  the  enduring 
prizefighter.  AVhen  the  pituitary  is  ecpially  well  adjusted,  one 
lias  the  heavy  weight  cliami)ion  type.    But  the  ability  to  scrap, 


372  CAST    GOLD    AXD    rORCELAIX    IXLAYS 

whether  curbed  by  education  or  euvironuiout,  or  not,  is  indelibly 
nuirked  in  the  canines.  As  one  of  our  ancestors  would  have 
learned  by  experience  that  his  short  and  blunt  canine  was  no 
great  weapon  in  a  tight  and  would  have  become  the  champion  of 
peace  instead  of  conflict,  so  also  the  present  man  prefers  discre- 
tion to  valor  because  of  his  inadequate  adrenal  endowment  or,  as 
one  may  term  it,  lack  of  biologic  equijoment  for  strife.  AVhether 
man  or  woman,  both  show  in  a  long  sharp  canine  an  atavistic 
remnant  of  a  ])ellicose  progenitor,  and  upon  j^roper  jjrovocation 
justify  the  above  contention. 

"Very  often  the  large  and  sharp  canine  in  a  woman  be- 
speaks the  aggressive  agitator,  jiublic  si^eaker,  or  militant  suf- 
fragette. Some  of  these  women  studied  from  the  point  of  view 
of  biologic  balance  possess  other  endocrine  markings,  showing 
that  they  are  not  women  to  the  full  extent  that  nature  intended 
the  average  woman  to  be.  The  woman  whose  skin  is  rough,  who 
finds  pleasure  in  curl^ing  wild  horses,  who  cares  not  for  the 
duties  of  home  life,  and  Avho  is  an  expert  administrator  (pur- 
posely using  the  masculine)  must  give  up  a  certain  amount  of 
natural  feminism  in  order  to  be  able  to  enjoy  and  accomplish 
the  alxjve  things.  Very  often  with  such  traits  goes  a  masculine 
hand,  a  mustached  lip,  a  large-pointed  canine,  and  a  deficient 
gonadodont.  The  sexual  psychopath  could  be  detected  by  a 
study  of  his  dental  apparatus,  and  the  endocrine  therapist  might 
supply  the  glandular  extract  that  would  give  a  more  natural 
trend  to  the  twisted  psyche  of  its  possesor. 

"The  spinster  who  truly  rejoices  in  her  single  blessedness 
does  not  do  so  from  choice,  but  rather  from  her  innate  prompt- 
ings. Being  less  of  a  woman  than  her  well-balanced  sister,  she 
does  not  require  the  society  of  a  man,  and  frequentlj^  shows  her 
genuine  distaste  for  such  company  by  an  appropriate  remark. 
In  her  pursuits  she  wants  to  dominate  and  frequently  fills  with 
credit  a  position  requiring  great  virility.  She  abhors  the  eve- 
ning gown,  and  wears  clothes  of  a  masculine  type,  low  heels,  no 
corsets,  side  pockets,  collar,  and  tie. 

"The  male  counterpart  with  short,  stumpy  and  dull  canines 
gives  up  some  of  his  primordial  male  aggressiveness,  and  be- 
comes the  Jacob  instead  of  the  hairy  P]sau.  The  kitchen  is  his 
place,  he  can  sing  in  high  notes,  never  a  basso,  and  has  the 


EXDOCniNODONTIA  373 

greatest  inward  storms  wlicii  IIh'  time  coiiios  for  him  to  propose 
marriage  to  his  lieart's  choice.  Sucli  a  man  stands  a  poor  chance 
of  being  accepted  by  a  girl  well  Inilanced  from  an  endocrine 
standpoint.  It  is  the  one  who  will  not  enlist  to  help  defend  his 
country,  but  will  offer  a  thousand  and  one  reasons  why  he  should 
not  fight,  that  war  is  a  reversion  to  l)arbaric  times,  etc.  Such 
men  are  afraid  that  a  gun  might  go  off,  and  in  business  are 
equally  nonprogressive.  The  eternal  clerk,  messenger  boy,  cook, 
and  other  nonprogressive  occupations  are  theirs.  Endurance, 
progressiveness,  discovery  go  hand  in  hand  with  an  endocrine 
system  that  is  jjerfect,  and  a  canine  tooth  that  fears  not  to  face 
antagonism  in  any  shape  or  form. 

"The  adrenodont  in  its  structure  gives  us  a  clue  to  the  ad- 
renal balance  of  the  individual.  There  is  another  characteristic 
of  the  adrenal  tooth,  the  color.  The  grinding  surface  of  such 
teeth  shows  a  marked  reddish  brown  coloration  (Cliayes),  and 
although  softer  in  texture  than  the  thyroid  or  pituitary  variety, 
they  have  a  greater  degree  of  endurance  (Cliayes).  Here  again 
is  a  hint  of  the  ability  of  adrenal  secretion  to  protect.  Old  men 
or  women  will  show  short  teeth  still  in  a  very  good  state  of 
preservation  and  most  freely  marked  with  this  reddish  brown 
pigment.  Younger  people  with  such  teeth  can  be  assured  of 
their  lasting  character,  and  it  is  astonishing  to  note  how  some  of 
them  remain  intact  regardless  of  the  lack  of  care  and  the  thick 
wall  of  tartar  that  surrounds  them.  Age  or  the  ability  to  grow 
old  goes  hand  in  hand  with  jDroper  adrenal  work,  of  course  with 
the  assistance  of  the  other  endocrines;  and  so  adrenal  markings 
in  the  form  of  j^igment  insure  not  only  the  life  of  the  tooth  but 
also  its  possessor.  Individuals  who  become  patients  on  account 
of  improper  adrenal  work  may  show  this  j^eculiarity  in  their 
teeth  also,  the  marking  here  indicating  the  gland  affected  as  well 
as  suggesting  the  proper  therapeutic  course  to  pursue. 

"Thymodoxtia.— The  tooth  of  the  baby  is  bluish  porclain, 
thin  at  the  grinding  edge,  and  translucent  in  that  part.  The 
tooth  in  some  children  shows  a  tendency  to  scalloping  at  the 
grinding  edge.  This  trait  nuiy  outlast  the  baby  and  in  rare 
occasions  be  found  in  the  adult.  The  other  infantile  character- 
istics may  go  with  it  such  as  a  red  cheek,  an  excellent  digestion 
and  a  tendencv  to  diarrheas.     The  finding-  of  such  teeth  in  the 


374:  CAST    GOLD    AXI)    rOllCELATX    IXIAYS 

adult  points  to  the  youth  of  the  individual,  regardless  of  years. 
In  this  i^ersistence  of  juvenile  characteristics,  one  mnst  always 
weigh  the  compensation  offered  l)y  the  other  glands  with  in- 
ternal secretion. 

"The  purpose  of  this  coinniunication  will  have  been  accom- 
plished if  the  physician  and  dentist  will  begin  to  see  in  the 
dental  apparatus  a  greater  j^uri^ose  than  the  sole  function  of 
mastication,  When  fully  studied  upon  lines  suggested  above,  a 
volume  of-  facts  will  be  discovered  that  heretofore  may  have 
manv  times  been  entirelv  overlooked. ' ' 


Dr.  Kaplan  calls  the  entire  ductless  gland  expression  as 
observed  in  A'arious  individuals  ''compensatory  d^mamics";  I 
feel  that  this  term  M'ill  be  misleading.  The  action  of  these 
glands,  particularly  the  adrenals,  the  thyroid,  and  the  pituitary 
is  dynamic  to  l)e  sure,  but  not  compensatory  in  the  true  sense 
of  the  word.  If  they  Avere  compensatory,  surgeons  might,  with 
impunity,  remoA'-e  any  one  of  these  glands  and  exjoect  the  other 
one  or  two  of  them  to  assume  the  function  of  the  one  remoA^ed. 

AVe  know  that  this  does  not  take  place.  As  a  matter  of  fact, 
the  remaining  glands  Avill  be  much  disturbed  in  their  expression 
of  function. 

So  close  is  the  interdependence  of  these  glands  in  their 
function,  that  not  one  may  be  hurt  or  tampered  Avith,  Avithout 
immediately  calling  forth  resentment  in  the  others. 

But  interdependence  of  dynamic  expression  is  not  now  and 
ever  can  be  compensatory  dynamics,  and  Dr.  Joseph  Fraenkel 
and  his  associates,  to  Avhom  most  of  us  owe  our  correct  informa- 
tion on  the  sul).if('t  of*  ductless  gland  activity,  their  i)hysiology 
and  function,  and  tlicii-  therapeutic  use  and  \'alue,  never  iiicant 
to,  and  ne\'('i'  did.  to  iiic  at  least,  com-cy  tlic  inroniialioii  oi-  iiii- 
])i-ession  that  they  wei'e  comjjensatory  in  llic  sense  in  w  liieli  i)i'. 
Kaplan  seems  to  conceive  them  to  l)e. 

Dr.  Kaplan  is  correct  in  a11i-il)ntiiig  to  the  duclless  gland 
cliain  a  marked  infhienee  upon  the  dental  apparatus,  its  forma- 
tion as  to  ])Osition  and  cpiality,  hence  i-esistance  to  destruction 
by  decay.  It  is  Aveli  estal)lis]ied,  Ijeyond  the  necessity  for  fur- 
thei-  \-ague  expefinieiitat  ion,  that  the  hi'eaking  down  ol'  d(  ntal 
tissues  to  wit,  teetii  and  envii'ons,  nia\'  he  niodi(ie<l  if  not  alto- 


ENDOCIIIXODOXTIA  O  I  O 

o-otliei',  at  least,  to  some  c'oiisi(lei-al)lo  oxtoiit  ])y  ductless  olarid 
tlierai)y.  I  called  tlic  attention  of  tlie  ))roression  to  tliis  sul),j<'ct 
about  two  and  one-lialt'  years  ai;'o  in  ni\'  thesis  on  tlie  functions 
of  the  teetli. 

Dr.  Ka])lan  is  a<i,ain  liasty  in  liis  uonieuclature.  Tliere  is 
no  sucli  thinf;-  as  tliyrodontia  or  ])ituitodontia  or  adrenodontia, 
etc.,  any  more  than  avc  could  imi)rovise  a  science  of  pneumo- 
dontia  or  intestinodontia;  a  happier  nanu^  for  his  article  would 
have  been  ''Endocrinodontia,"  1)ecause  such  a  name  would  have 
covered  the  subject. 

His  remarks  re<;'ardinf;'  the  influence  of  the  gonads  upon  the 
])()sition  of  the  latei'als  in  the  superior  maxillcr  is  correct,  l)ut 
that  tliis  intiuence  is  a  crossed  one  has  not  been  l)orne  out  in  all 
experiences,  also  it  nuist  l)e  rememljered  that  this  influence  is 
not  a  direct  one  but  is  exerted  tlirou<;'h  the  ])ituitary. 

Thyroidal  teeth  are  louft',  well-rounded,  bell-shaped,  and  of 
a  beautiful  bluish  white  texture  shadini;-  into  yellow  at  the 
cervical  margin. 

Pituitary  teeth  are  short  or  long,  not  so  bell-shaped,  more 
or  less  square-shaped  anteriors  are  the  rule,  yelloAvish  gray  in 
color. 

Adrenal  or  so-called  adrenal  teeth  are  small  bell-shaped 
organs  rapidly  yielding  to  attritional  wear,  occlusal  surfaces 
show  reddish  stains,  they  resist  decay  remarkably  well,  are 
yellowish  white  in  color,  quite  yellow  at  the  cervical  margin. 
Erosion  of  teeth  at  cervical  portions  is,  to  my  mind,  an  adrenal 
phenomenon  and  numifests  itself  in  many  cases  which  are  poten- 
tially neoplasmic.  The  same  is  true  of  teeth  which  seem  to 
possess  an  inherent  jn-inciple  of  innnnnity. 

Thymic  teeth  may  be  thyroidal  or  pituitary  in  character 
with  the  addition  of  scalloped,  fan-shaped  occlusal  or  incisal 
surfaces.  They  are  very  translucent  and  of  a  milky  white  or 
bluish  white  color. 

May  we  not  coiudude  from  all  the  foregoing  that: 

When  a  little  child  presents  himself  to  ns  and  the  little 
one's  teeth  are  in  malrelation  to  one  another,  we  ought  to  know 
hoAV  to  correct  this  situation  Avithout  harnessing  this  little  mas- 
ticating apparatus  in  all  sorts  of  unspeakable  and  distressing- 
appliances,  furthermore,  we  ought  to  realize  that  this  very  mal- 


376  CAST    COLD    AND    POIH'KI.AI  X    IXI.AYS 

relation  of  the  tcctli  is  an  expression  of  a  constitutional  state  to 
be  ministered  to,  not  by  irritating  the  structiires  in  tlie  month, 
l)nt  l)y  gently  recalling  to  its  proper  sphere  of  activity  and 
sn]iervision,  tlie  delinquent  part  of  the  mechanism,  the  tempo- 
I'ary  aberi'ation  of  Avhicli  caused  the  malrelation — a  thymopitu- 
itary  state. 

AVlien  a  little  one  wliose  teeth  decay  readily,  despite  all 
attention  to  iiygiene,  presents  himself  to  us  for  our  attention 
and  aid,  we  should  so  minister  to  the  jjotential  man  or  woman 
in  it  as  to  recall  to  its  projjer  sj^here  of  activity  and  suiDervisiou, 
the  delinquent  i^art  of  the  mechanism,  the  temporary  aberration 
of  which  caused  the  dystrophy — a  thymothyroidal  state. 

A\'lu'n  a  little  jjatient  whose  posterior  teeth  are  in  malrela- 
tion and  show  reddish  stains  on  the  occlusal  surfaces,  presents 
liims(df  to  us  for  attention,  we  should  be  aljle  to  recognize  an 
expression  of  a  thymojjituitoadrenal  stress  and  so  minister  to 
the  little  one  as  to  recall  to  their  proper  sphere  of  activity  and 
supervision  the  delinquent  parts  of  the  mechanism,  the  tem- 
porary aberration  of  which  caused  the  dystrophy. 

AVhen  a  little  patient  whose  teeth  in  the  premaxillary  region 
of  the  maxilla'  are  in  malrelation  presents  liimself,  we  should 
recognize  this  as  aprenatal  pituitary  state  and  so  minister  to 
the  little  one  as  to  recall  into  proper  sphere  of  activity  and 
supervision,  the  delinquent  part  of  the  mechanism  resj^onsible 
for  the  pai-ticulai-  exj)ressioH. 

When  a  little  jjatient  wJiose  lower  anterior  teeth  are  in  mal- 
relation, jjresents  himself,  we  should  recognize  this  as  a  post- 
natal ])ituitary  state  and  so  minister  to  the  little  one  as  to  recall 
to  liai-iii()iiioiis  int(  i-])lay  the  delinquent  pai't  of  the  mechanism, 
aiiswci-able  I'oi-  1h<'  pailicular  expression. 

A  little  child  who  pi'esoits  himself  with  his  U])])er  laterals 
in  loi-ion,  is  ])osse.<se(l  of  some  gonadial  disbalance,  indicating, 
j)('i'liaj)S,  a  s(  iiile  gonadial  apjiaialns,  a  i)i-enatal  pituitogonadial 
state  and  should  be  so  treated  as  to  ix'call,  if  i)Ossible,  to  jn'oper 
spliere  of  activity  and  su])ervision,  that  ])ai't  of  the  mechanism, 
answerabh*  I'ov  the  paiiiculai' <^'X})i"ession. 

These  f<'W  j)ai'agraplis  may  be  sumni('(l  up  in  the  following 
senlenees: 

First,  denlilion   as   to   lime,   is   a  lh\ni(|])ituitar3'    function. 


EXDOCr.IXODOXTIA  o  (  I 

Socoik],  (lentil ion  as  to  ])()siti()ii,  is  a  tliyinopituitary  and 
ftoiiado-pituilary  function. 

Third,  dentition  as  to  quality  is  a  tliyropituitary  function. 

Fourtli,  dentition  as  to  resistance  is  a  tliyroadrenal  func- 
tion. 

It  follows  fi'oni  this  that  the  first  pei-inanent  molar  erupts 
in  normal  position  in  the  upper  arch  when  the  thymothyi'oidal 
apparatus  is  in  balance  and  when  there  is  no  prenatal  jjituitary 
disturbance. 

It  erupts  in  noinial  position  in  the  lower  arch  when  the 
thymothyroidal  apparatus  is  in  balance  and  when  there  is  no 
postnatal  pituitary  disturbance  before  six  years  of  age.  The 
above  holds  true  in  sequence  mentioned  for  the  upper  and  lower 
temporary  set  of  teeth. 

The  bicuspids  and  second  permanent  molars  and  cusj^ids 
are  most  often  in  malrelation  in  females,  because  they  erupt 
at  a  time  of  or  innnediately  after  j^uberty  or  at  a  period  when 
the  pituitary  is  called  upon  to  adjust  itself  to  and  to  interplay 
with  the  awakened  gonadial  apparatus,  a  critical  time  in  the 
life  of  a  female  individual.  The  same  holds  true  in  a  male  per- 
son but  to  a  lesser  degree. 

The  torsion  of  the  permanent  laterals  indicates  an  anomaly 
of  the  uterus  as  to  position  or  some  ovarian  difficulty  in  the 
female  and  some  testicular  disturbance  in  the  male.  When  the 
torsion  is  very  decided  in  the  latter,  one  may  safely  assume  the 
presence  of  a  varicocele  in  the  patient. 

If  the  permanent  cuspids  are  forced  out  of  j^osition  by 
apparent  lack  of  space,  they  point  in  females  to  ovarian  dis- 
turbances such  as  cysts,  fibroids,  etc.  In  males  they  are  an 
indication  of  recurrent  obscure  pains  in  the  lower  abdominal 
region  with  sensitive  areas  in  the  region  of  the  groins. 

If  these  cuspids  are  markedly  prehensile  in  formation,  they 
indicate  an  abundance  of  the  sexual  urge  as  mentioned  in  a 
l)revious  chapter  of  the  book. 

Individuals  whose  teeth  suffer  from  erosion  at  the  cervical 
margins  and  upon  the  labial  surfaces  and  which  present  an 
enamel  surface  which  is  highly  polished  and  of  a  greenish  white 
hue  bid  fair  to  be  candidates  for  neoplasms,  particularly  so 
when  red-haired. 


378  CAST    COLD    AND    rolJCELAIX    INLAYS 

Till'  s))at'iiii;-  of  liic  anterior  upijer  teetli  is  a  pituitary  si^'- 
uature  aiul  often  tells  a  story  of  headaches,  eoustipation,  and 
otiier  gastric  distur])ances.   " 

Teeth,  mIucIi  have  undergone  marked  change  in  macro- 
scopic appearance  due  to  attrition,  invariably  tell,  in  dark  peo- 
ple, a  story  of  freedom  from  infectious  diseases,  outside  of 
perhaps  measles  and  diphtheria  or  whooi^ing  cough,  hut  also 
point  to  the  predisposition  of  the  person  to  disturbances  of  a 
circulatory,  nature  and  afflictions  of  the  lower  j)ortions  of  the 
lai'ge  intestines. 

AVe  see  cases  of  iiiatui-e  age  which  present  teeth  of  marked 
youthful  ajDpearance.  We  call  them  thymic  teeth  and  they  tell 
a  story  of  a  pituitary  and  gonadial  battle  against  a  powerfully 
entrenched  thymus,  resulting  in  a  comi)roniise,  definitely  ex- 
pressed in  an  occlusal  relation  between  upper  and  lower  teeth 
which  permits  of  the  virtual  j^^i'P^tuation  of  the  incisal  and 
occlusal  surfaces  characteristic  of  children's  teeth. 

I  am  convinced  that  a  deep  study  of  the  endocrines  and  a 
careful  therapeutic  application  of  them,  would,  to  a  great  ex- 
tent, if  not  altogether,  eliminate  the  endless  dystrophies  mani- 
festing themselves  in  the  oral  cavity;  and  thus  obviate  the  call 
for  a  great  number  of  tedious,  and  for  patients,  very  painful 
operations. 

I  appreciate  the  fact  that  many  will  read  this  chapter  with 
great  skepticism,  and  I  can  readily  understand  why  this  wdll 
be  so;  but  I  "would  ask  these  readers  to  abide  in  faith  and 
read  some  of  the  books  to  be  reconunended  and  then  carefully 
observe  their  patients,  question  them  at  length  and  so  learn 
from  their  own  daily  practice  to  understand  the  wonderful  in- 
terdependence which  exists  l)etween  the  endocrines  and  the  den- 
tal aj)])ai'alus  and  liow  pci'Tccllx'  llicx'  cxpi'ess  tlieinsejves  in  the 
size,  textnrc,  (|uali1>',  and  position  of  llic  lectli  and  their  envi- 
ronment. 

The  Creative  Force  at  Work 

In  llic  ac('()nipan\iiig  diagram  (i^'ig.  .'572)  two  ti'iangles  are 
seen  suj)ej"imj)os('d  one  npon  the  oliu'i-,  making  a  six-pointed 
star — the  Protector  of   l)a\id.      It    i-('j)i-esents  the  conception  I 


KX!)()("i;i  XODOXTIA 


.179 


]ia\('  of  the  I'liixci'sal  Spirit  or  AJiiid  oi'  Soul  working-  iij)oii 
itself  and  L'X])aii(liii^'  in  coiisciousiicss  IVoiii  witliin  oiit\vai"(l,  so 
that  it  l)(',<;iiis  to  manifest  itscll:'  in  various  ways  on  (liilerent 
planes  (creation). 

The  i'aet  that  tlies(»  ti'iang'les  are  so  ])laeed  tliat  one  pre- 
sents with  its  apex  (h)\vn\vai'd  and  the  otlier  with  the  ajx'x  u])- 
ward,  will  mean  nmcli  to  tliose  wlio  liavo  studied  occultism  and 
ai'e  raniiliai'  with  the  litei'atui'e  on  svmholism. 


AVe  see  here  the  lari2,e  ^1  in  the  center  of  the  illustration. 
In  tlie  apicari)ortion  of  the  A  we  see  an  S  to  represent  the  Sun, 
the  energizer,  the  father,  lie,  who  with  his  warmth,  animates  the 
Universe.  Dii-ectly  above,  we  see  the  point  of  the  star  marked 
PP  representing  the  pituitary  beneath  which  rests  the  pineal. 
AVithin  this  point  of  the  star,  the  M  repi-esents  the  Moon  with 
its  i^sychic  significance  to  man. 


obU  CAST    GOLD    AXl)    POIICELAIX    IXLAYS 

Till'  point  on  the  uppiT  left  marked  T  represents  the  thy- 
roid and  the  R  within  it  stands  for  the  restless,  ever-moving 
atmosphere. 

The  point  on  the  rig-lit,  also  marked  T  represents  the  thy- 
mus or  youth  or  beginning  of  man.  The  V  within  this  point 
represents  the  vegetable  kingdom,  even  as  the  R  in  the  opposite 
point  represents  the  mineral  kingdom  ^^  ith  its  finely-divided 
silicious  and  other  mineral  iDarticles  floating  in  the  ether.  This 
V  representing  the  flowers  and  trees  and  leaves  upon  the  trees 
is  symbolic  of  ever-recurring  youth. 

The  two  points  below,  the  right  and  left  A  represent  the 
adrenal  bodies  or  energy  made  manifest  on  the  human  plane. 
The  TT"5  within  these  i^oints  represent  the  waters  of  the  earth. 

And  finally,  the  point  below  marked  G  for  gonads,  express- 
ing iimnoitality  on  the  proereative  plane.  The  E  within  this 
l)oint  represents  earth  or  the  place  where  man  must  reach  a 
certain  stage  in  his  unfoldment  in  order  to  be  worthy  of  his 
Creator. 

Please  note  the  numl)er  of  intercommunicating  lines  along 
which  impulses  or  hormones  or  whatever  we  may  choose  to  call 
them  may  travel. 

If  we  now  look  upon  the  large  central  J  as  the  heart  of 
man,  we  shall  have  a  picture  of  him  as  the  microcosm  within 
the  Universe  and  we  may  note  how  the  adrenal,  the  jDituitary, 
the  pineal,  the  thyroid,  the  thymus,  and  the  gonads  all  liave 
their  heart  valency  and  how  conversely  the  heart  presents  its 
radiant  impulses  impartially  to  all  of  them. 

The  vast  influence  of  these  glands  may  be  further  graph- 
ically illustrated  l)y  lines  or  arrows  going  from  the  six  points 
of  llie  stai-  to  all  parts  of  llic  body.  Such  as  skin,  hair,  teeth, 
muscles,  ligaments,  lungs,  li\cr,  howcls,  eyes,  ears,  nose,  throat, 
that  is,  ])liai-yii\-,  lai-ynx,  tonsils,  etc. 

The  network  is  so  vast  and  the  interdependence  so  inti- 
mate that  it  would  recjuii-e  a  volume  of  considerable  size  to 
cover  tlie  subject. 

1  want  to  again  express  my  sincefe  obligation  to  those  wjio 
before  me  ha\'e  work'ed  in  this  (iehl,  and  my  keen  a|)pi'eei;it  ion 
of  their  efforts.      If   I    liaNc   omittiMl   i;i\ini;-  an\'   one  their  due 


Kxnr)ri;iX()i)r)XT[A  381 

credit  foi"  any  ([notation  oi*  illnsti'ation,  I  licfcwitli  acloiowledge 
my  debt. 

To  all  who  wonld  delve  more  deeply  into  tlie  various  sub- 
jects treate<l,  I  would  earnestly  I'eeonnnend  the  books  enumer- 
ated below. 


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Chieayo. 

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M.A.,  F.A.S.,  1903-1913. 
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The  Story  of  the  Mind.     By  James  Mark  Baldwin,  1902-1913. 

Old  Age  Deferred.     By  Arnold  Lorand,  M.D.,  published  by  F.  A.  Davis  Co.,  1913. 

Principles  of  Light  and  Color.  By  Edwin  D.  Babitt,  published  by  Babitt  &  Co., 
New  York  City,  1878. 

Six  Thousand  Years  of  History.  By  Edgar  Sanderson,  A.^Sf.;  John  Porter  Lam- 
berton,  A.M.;  Charles  Morris,  A.M.;  and  others;  pu1)lished  by  Thomas 
Nolan,  Philadelphia,  1908. 

The  Brain.  By  Emanuel  Swedenborg,  vols,  i  and  ii,  published  by  American  Sweden- 
borg  Printing  and  Pub.   Soc,  New  York  City. 

The  Economy  of  the  Animal  Kingdom.  By  Emanuel  Swedenborg,  vols.  1  and  ii, 
published  by  American  Swedenborg  Printing  and  Pub.  Soc,  New  York  City. 

The  Soul  or  Rational  Psychology.  By  Emanuel  Swedenborg,  published  ])y  Ameri- 
can  Swedenborg  Printing  and  Pub.  Co.,  New  York  City. 

The  Cross  of  the  Magi.  By  Frank  C.  Higgins,  F.R.N. S.,  published  l)y  Roger 
Brothers,  New  York  City,  1912. 

The  Endocrine  Organs.  By  E.'  A.  Schafer,  LL.D.,  D.Sc,  M.D.,  F.R.S.,  published 
by  Longmans,  Greene  &  Co.,  New  York  City,  1916. 

The  Internal  Secretions.  By  E.  Gley,  M.D.,  (translated  by  Dr.  Maurice  Fish- 
berg),  published  by  Paul  B.  Iloeber. 

The  N'ew  Standard  Encyclopedia.     Funk  &  Wagnalls  Co.,  New  York  City. 

The  Thyroid  Gland.  By  Robert  McC.\rrison.  M.D.,  D.Sc,  F.R.C.P.,  published  by 
Wm.  Wood  &  Co.,  New  York  City,  1917. 


382-  CAST  (lOTJ)  AXD  POECELATX  IXLAYS 

The  Practitioner.     Special  Xvmber  ox  the  Internal  Skcretions.     Puljlishod  by 
"The  Prai'titioncr, " '  Ltd.,  Loiulon. 

Januarij,  1915 

The  Theory  of  Internal  Secretion  :  Its  Hlstory  and  Development.     By  E. 

Gley,  M.D.,  LL.D. 
Thb  Physiology  of  the  Thyroid  Glaxd.     By  H.  IT.  Dale,  :\I.A.,  M.D.,  F.R.S. 
Thyroid  Insufficiency.    By  Dr.  E.  Heitoghe. 
Endemic  Goitre.     By  Major  Robert  MeCarrison,  M.D.,  F.E.C.P. 
Exophthalmic  Goitre.     By  Leonard  Williams,  M.D.,  M.R.C.P- 
The  Parathyroid  Glands.     By  Arthur  F.  Hertz,  M.A.,  F.E.C.P. 
The  Physiology  of  the  Chromaffin  System.    By  D.  Xocl  Patoii,  M.D.,  B.Sc, 

F.R.S. 
The  Adrenal  Glands.    By  T.  E.  Elliott,  M.D.,  F.R.S. 
Pluriglandular  Insufficiency,  Its  Incidence  and  Treatment.    By  Henry  R. 

narrower,  M.D. 
The  Functions  of  the  Pituitary  Body.    By  Swale  Vii!ceiit,  M.D.,  D.Se.,  F.RS. 

Edin.),  F.R.S.   (Can.). 

F(hniari/,  1915 

The  Theory  of  the  Internal  Secretions.    By  Charles  E.  dc  M.  Sajous.  M.D., 

LL.D. 
Thyroid  Insufficiency.     By  Leopold-Levi,  M.D. 
The  Pancreas.     By  Carl  von  Noorden,  M.D. 
The  Internal  Secretions  of  the  Alimentary  Canal.    By  W.  Langdon  Brown, 

M.A.,  F.R.C.P. 
The  Use  of  Hormones  in  Medicine.     By  Geo.  R.  Mnrrav,  M.A.,  M.D.,  D.C.L. 

F.R.C.P. 
The  Use  ok  Hormones  in  Ciiidren's  Diseases.     By   Herl)eit   Ewan  Waller, 

M.R.,  C.S.,  L.R.,  C.P. 
The  Use  of  Hormones  in  Gynecological  and  Obstetricial  Disorders.    By  W. 

Blair  Bell,  B.S.,  M.D. 
Hormones  in  Rel.vtion  to  Diseases  of  the  Skin.    Bv  J.  M.  H.  Macleod,  M.D., 

M.R.C.P. 

Internal  Secretions  and  the  Psychoses.    By  Theo.  B.  Hyslop,  M.D.,  F.R.S.E. 
Thyroid  Insufficiency  in  General  Practice.    By  J.  Parlaue  Granger,  F.E.C.S. 
The  AVorks  of  Plato.     Nottingham  Society  Edition. 

The  Works  of  Thomas  Trowakd.     Goodyear  Book  Concern,  New  York  City. 
Theory  and  Practice  of  Thyroid  Therapy.    By  Herbert  Ewan  Waller,  M.D.,  D.Sc, 

L.R.,  C.F.,  published  by  Wm.  Wood  &  Co.,  191]. 
Vagotonia.     By  Eppinger  and  Hess,  monograph  series  Xo.  20^  ]mlilisli:'d  by  Xervons 
and  Mental  Diseases  Publishiiig  Co.,  1915. 


INDEX 


Absorption,   of   liglit,   308 

Acid   cup    for   liydrofluoric    acid,    210 

Action,   cooidiiiiitc,   mental   and  physical, 

43 
Active  reciprocal  functions  of  the  teeth, 
general,  58 
special,   59 
Adrenal   bodies,   3G3 
Adrenal   teeth,   375 
Adrenodont,  373 
Adrenodontia,   371 
Adrenotrop,  365 
Agitation,    peiiod    of,    in    alloying    gold 

and   platinum,    185 
Alarm     clock     attached     to     investment 

mixer,  168,  169 
Alimentary    functions,    of    the    teeth,    60 
Allopathic   thought,  366 
Alloj'ing  gold  and  platinum,  method  of, 

183 
Alterative   factor   in   cavitv   preparation, 

71 
Alumina,  composition  of,  163 
Amalgam  die,  making  of  the,  148 

use   of  in   making  porcelain  insert, 
295 
fillings,  poorly  executed,  as  a  cause  of 
multilated      occlusal      surfaces, 
236 
Andjer-colored  glasses,  184 
Amorphous  silicon,  160 
Anatomic  articulator,  246 
Anatomy,  tooth,  knowledge  of,  necessary 

to  inlay  worker,   152 
Angle  of  incidence  in  reflection  of  light, 

305 
Angles  of  bicuspids,  68 
of  cuspids,   67 
of  incisor  teeth.  Go 
of  molars,  68 
Anterior  teeth,  cavity  tray  for,  144 
of   upper   jaw,    stress    index    for,    115 
splinting  of,  222 
Articulator,  anatomic,  246 
Asbestos,   ground,   and   water  paste,  295 
Attrition,   a  cause   of   mutilation   of   oc- 
clusal surface,  236 
causes  of,  242 
definition   of,   242 
effects   of,  244 
teeth  worn  down  by,  101 
types   of,  265 


Auditory  sense,  26 
Augmentation,   362 
Automatic   mixer,   167,   168,   170 
Automatic   wax  warmer,   131,   132 

B 

Badger   brush,    169 
Baly,  310 

Bicuspid    presenting    a    complex    cavity, 
113 
presenting    a    compound    disto-occlusal 

cavity,  83 
presenting  a   mesio-disto-occlusal   cavi- 
ty, 87,  91,  111 
presenting  a  niesio-occlusal  cavitv,  85, 

89 
presenting   a  mesio-occluso-distal   cavi- 

ty,  344 
presenting    simple    occlusal    cavity,    81 
Bicuspids,  angles  of,  68 
surfaces  of,  68 
stress   index    for,   81-115 
Bleaching  of  wax,  127 
Brass  cups,  350 
Brewster,  Sir  David,  303 
Brute   Force,   37 
Buccal  cavity  in  a  molar,  99 
Bulk   to   be   added   to    teeth   worn   down 

by  attrition,  244 
Bunsen   burner   for   diying   mold,   174 
Burning  out  the  wax  model,  173 
Burnishers,  use  of,  in  placing  the  inlay, 

214 
Burnishing  of  margins  after  cementation 

of  inlay,  217 
Burnishing  the  wax  inlay,   154 
Byram,    323,   325 

C 
Calcium,  composition  of,   162 

metabolism,   366 
Carbonic   acid  gas,  356 
Cardioauxiliarv    functions    of    the    teeth, 

58 
Carving  of  molar  crown,  257 
Carving    the    wax    inlay    by    the    direct 

method,   131 
Cast  bases,  gold  for,  186 
Cast   gold  complement   for   a   tooth   pre- 
senting    a      mesio-disto-occlusal 
cavity,    120 
Cast  gold  inlay,  62  (Sec  also  Gold  inlays) 
and  porcelain  for  restoration  of  frac- 
tured lower  lateral,  279 


383 


584 


INDEX 


Cast   gold— Cont  M. 

and  porcelain  inlay  for  compound  dis- 
to-occlusal  cavity  in  biscuspid, 
83 

for  mosio-ocdusal  cavity  in  bi- 
cuspid, 89 

and    porcelain    insert    for   mesio-labio- 
linguo-incisal   deficiency,  289 
in  lower  cuspid,  281,  283 
method  of  making,  286,  287 

and  synthetic  porcelain  for  mesio-dis- 
to-labio-incisal    deficiency    in    a 
central,   291 
restoration  of  lateral  bv  means  of, 
273;  285 

cementation  of,  213,  215 

cleansing  of,  before   cementation,   216 

contraindication,   269 

defined,   63 

extensive  restorations  of  occlusal  bal- 
ance by  means  of,  236 

for  complex  cavity  in  a  bicuspid,   113 
in  a  molar,  105 

for  deficiencv  of  occlusal  third  of  mo- 
lar, 103 

for  a  disto-buccal  cavity  in  a  molar, 
97 

for  disto-occlusal  cavity  in  a  molar,  97 

for  disto-occluso-buccal  cavity  in  a 
molar,  107 

for  labio-  or  bucco-occlusal  cavity  in 
a   molar,   93 

for  mesio-disto-occlusal  cavity  in  a  bi- 
cuspid, 87,  91,  111 

for  mesio-disto-occlusal  cavity  a  n  d 
buccal  cavity  in  a  molar,  99 

for  mesio-disto-occluso-palatal  cavity 
in  a  molar,  109 

for  mesio-ocelusal  cavity  in  bicuspid, 
85 

for  simple  occlusal  cavitv  in  bicuspid, 
81 

formulae   for,   185 

indirect  method   of  making,   139 

mesio-disto-occlusal,  120 

placing  of,   in   cavity,   213 

j)olishing   the,   213 

splinting  of  loose  teeth  by  means  of, 
218,   235 

seating  the,   217 
Cast    gold    inlays    for    teeth    woiii    down 
by  attrition,   101 

for    lingual    surfaces    of    tectli    to    be 
splinted,  231 
Casting,  cleansing  of  the,  in  hydrofluoric 
acid    and    sodium    bicarbonate, 
209 

machines,  test  for,  205 

of  metal   under  pressure,   197 

of  molten  mf?tal  into  the  mold,  ma- 
chines   employed    in,    187 


Casting — Cont  'd. 

of  molten  metal  into  the  mold,  178. 
Cavities  classified,   74 
Cavity,  buccal,  in  a  molar,  99 
cervical,  in  a  molar,  341 
cervical  proximal,  in  a  lateral,  341 
complex,   in   a   bicuspid,   113 

in   a   molar,   105 
compound  disto-occlusal,  in  a  bicusj^id, 

83 
disto-buccal,  in  a  molar,  97 
disto-labial,  in  a  central,  338 
disto-occlusal,  in  a  molar,  95,  97,  342, 

343 
disto-occluso-buccal,   in   molar,   107 
labio-disto-lingual,  in  a  lateral,  339 
labio-occlusal,  in  a  molar,  342 
labio-    or    bucco-occlusal,    in    a    molar, 

93 
linguo-mesial,  in  a  lateral,  340 
mesio-    and    disto-proximal,    in    a   cen- 
tral,  293 
mesio-disto-occlusal,  120 
in   a  bicuspid,   87,   91,   111 
in  a  molar,  99,  343 
mesio-disto-occluso-palatal,  in  a  molar, 

109 
mesio-occlusal,  in   a  bicuspid,  85,  89 

in  a  molar,  343 
mesio-occluso-distal,  in  a  bicuspid,  344 
preparation,  65,   76 

for   porcelain   inlay,   328 
mesio-disto-occlusal,    121 
of  floor  of  a,  114 
selection  or  election  of  a  case  present- 
ing a,  64 
simple  occlusal,  in  bicusi^id,  81 
Cement,  crystallization  of,  217 

mixing  of,   216 
Cementation  of  the  inlay,  213,  215 
Central,    fractured,    restoration    of,    271 
left    upper,    presenting    a    mesio-disto- 
labio-incisal       deficiency,       cast 
gold  inlay  and  synthetic  porce- 
lain   insert    for,    291 
right  upper,  ])resenting  an  eroded  and 
pitted    labial   surface,    a   mesio- 
and    disto-proximal    cavity,    293 
presenting    mesio-labio-linguo-incisal 
deficiency,   289 
Central    nervous    system,    injury    to,    due 

to  jacket  crowns,  293 
Centrifugal    casting    machines,    188,    189 

force,   188,   189 
Cervical  cavity  in  a  molar,  341 
Cervical  proximal  cavity  in  a  lateral,  341 
Charcoal  bloi'k  witli  <lepression  to  act  as 

a  ciucible,   183 
Chart  of  prismatic  colors,  316,  317 
Chisels  foi-  tnofli  structure  cutting,  72 


INIU'A' 


.•js.-) 


( 'liidiiiat  ii-   ;Llicii:itiiiii,   .'iOt 
Chuirli,  A.    II..  .-.l^ 
Clam])  ami    nililicr   cliiiii,    7.'! 
Classificatiiiii    o\'    I'lmi-tiniis    of    fcctli,    58 
('Icansiiii;   ot'  tin'  casting  in  hydrofluoric 
aiiil   ami  in  a   sodium  bicarl)on- 
atc    liatli,    lid!) 
Clcaiisiiii;-    the    cavity    l);'f'oio    eemonting 

till'    irday,   21() 
Cicvi'laiid     Dental    castini^-    macliino,    198 
Colli    liask,    as    a     iircvontive    of    distor- 
tion ni'  tho  mold,  180 
Color   in    K'latiim    to   tho  porcelain   inlay, 
.•',(11) 
intorni;  Mliat(\    '■'<]'> 

of    jjold    when    silicates    are    used,    287 
of  |ii)i-celain,  ll'A 
|ilieiionieiui  of,  302 
("oliiis.    conijdenientarv,    ,318,    .j19 
harmony   of,    317 
l)rimary,    312 
prismatic,   317 
rainljow,    317 
secondaiy,    313 
tertiary,   314 
Condjiniiig  weight  of  gold,   182 
Compensatory     dynamics     of     tlie     cndo- 

crines,  365 
Complementary  colors,  318,   319 
Complex  cavity,  defined,  75 
in    a   bicuspid,   113 
in    a    molar,    105 
showing   planes,   78 
Conijiosition    of   wax,    127 
Comi^ound   cavity   defined,   74 
Compound   cavities,   prej)aration    of,    for 

porcelain,    329 
Compound  disto-occlusal  cavity  in  bicus- 
pid, 83 
Compound,    fornuda   for,    164 
investment,   158 
refractory,  158 
Compound-carrying  trays,  method  of  tak- 
ing impression  with,  146 
Construction  of  splint  for  restoration  of 
occlusal  balance  in  cases  of  at- 
trition, 245 
Contact  lines,  215 
points,  215 

proximal,    determination    of,    between 
molars,    258 
Coordinate   action,    mental   and   physical, 

42 
Coordinate  mental  efforts,  factors  induc- 
ing,   24 
Copper  alloy,  use  of,  in  making  amalgam 

die,   148 
Copper  band  for  making  wax  inlay,  136 
Cosmetic    functions   of   the   teeth,    58 


('osmetic  rea.sons  for  not  using  gold  for 

tho   inlay,   269 
Creation,  47,  379 
Creative  force,  48 
Crown,    molar,   carving   of,   257 
Crystallization    of    amalgam    die,    151 
of   cement,   217 
of  the  mold,  171 
Cuspid,  lower,  restored  by  cast  gold  in- 
lay   and    porcelain    in.sert,    281, 
283 
presenting  cavity,  297 
upper    right,    presenting    a    prehenso- 
labio-linguo-mesial         deficiency, 
399 
Cus[)ids,  angles  of,  67 
surfaces  of,  67 

D 

David,  protector   of,   379 

Defensive  functions  of   the   teeth,   58 

Dentistry,  50 

Dentition,   as  to  position,   a   thymopitui- 
tary  and  gonadopituitary   func- 
tion,  377 
as    to    cjuaiity,    a    thyroiiituitary    func- 
tion,   377 
as   to   resistance,   a   thyroadrenal   func- 
tion, 377 
as  to  time,  a  thvmopituitarv  function, 
376 

Depth  for  cavity,  295 

Developmental    functions    of    the    teeth, 
58 

Die,  amalgam,  making  of  the,   148 

for  procedure  by  indirect  method,  139 

Direct  method,  advantages  of,  140 

Direct    method    of    making    and    carving 
the  wax  inlay,   131 

Direct  pressure  machine,  200 

Diseases,  endocrine  glands  in  relation  to, 
366 

Di?to-buccal   cavity   in   an   upper   molar, 
97 

Disto-occlusal  cavitv  in  a  molar,  95,  97, 
342,   343 

Disto-occlusal   cavity   tray,   144 

Disto-occluso-buccal    cavity    in    a    molar, 
107 

Distorted  mold,  due  to  use  of  hot  flask, 
179 

Drying   out    the   mold,    173 

Ductless   glands,    359 

E 

Elastic     meml)rane     surrounding     teeth, 

function  of,  54 
Elasticity   of   suspension   ligament,   118 
Election  of  the  case  presenting  a  cavity, 

64 


3SG 


IXDEX 


Eli^iii      \;u'iuiin      i-;i?;tiiiy     in;u*liiiie      and 

Hasks,  19:2 
Enamel  seat  of  inlay,  77 
Euilocrino  giaiuls,  in  ii'lation  to  diseases, 

gonads,    364 

pineal,  363 

pituitary,    363 

thyroid,  363 

thymus,    363 

suprarenal   capsules,   363 
Endoerines,  362 

compensatory  dynamics  of,  36.3 
Endocrinodontia,   359 
Endocrinology,  study  of,   362 
Errors  and  accidents  primary   causes  of 

human  ills,   49 
Ether,    elastic,   in    relation    to    light,    303 
Eucalyptol  compound,  235 
Evolution,  48 

Excess  metal,  removal  of,  213 
Exercise  of  tissues  essential,  55 
Extirpated  pulp,  279 

Extirpation  of  pulp  in  large  restorations, 
276 


Face,  normal,  measuienients  for,  249,  255 
Feldspar,    323 

Fillings,    amalgam,    jjoorly    executed,    as 
causes  of  mutilation'  of  occlusal 
surface,  236 
Flask,  special,  204 

Taggart,  204 
Floor  of  a  cavity,  preparation  of,  114 
Foil  matrix  for  porcelain  inlav,  making 

the,   333 
Formative   factor  iji   cavity   preparation, 

71 
Formula  for  a  compound,  164 
Fractured   central,   restored   by  gold   in- 
lay   and    porcelain    or    the    sili- 
cates, 271 
Fractured  lower  lateral,   279 
Frail  teeth,  gold  for  inlays  in,  186 
Function  of  elastic  membrane  surround- 
ing teeth,  54 
Functions  of  the  teeth,  52 
active   reciprocal,   58 
general,  58 
special,  58 
passive  reciprocal,  58 
cosmetic,   58 
defensive,  58 
dcvclop)mental,    58 
phonetic,    58 
Fuiiiace,  I'hitchock,  175 
Fusing  of  j)Orcclain,  325 
Fusing   j)oint   of   gold,   182 
of  platinum,  182 


G 

Gases,   aljsorption   of   light   by,   3U9 
Gauge    of    wire    for    supplemental    pins, 

79 
Gelatin  impression   of  a  model,   118 
General    active    reciprocal    functions    of 

the  teeth,  58 
Geometric  construction  of  molars,  257 
Geometric  landmarks   of   teeth,   65 
Gingivae,  condition  of,  in  cases  of  attri- 
tion, 243 
Glands,   ductless,   359 
Glass,  color  of,  311 
Glazbrook,    304 
Gold,  alloving  with  platinum,   183 

color   of,   287 

combining  weight  of,  182 

for  cast  bases,  186 

for  inlay  work,  182,  186 

for  saddles,  186 

fusing   jioint   of,    182 

inlay,  and  porcelain  or  the  silicates  in 
a   fractured  coutial,   271 
and   the   silicates    or   porcelain,    269 

and    silicate    cement    to    restore    frac- 
tured lateral,  275 
formula;  for,   185 

specific  gravity,  182 

symbol,    182 
Gonadontia,  369 
Gonadotroi^,    365 
Gonads,    364 
Graphite  flakes,  in  investment,  106 

paste,  233 

post,  229 
Grimaldi,  303 

Grinding   the   porcelain   matrix,   352 
Gum  tragacanth,   353 
(rypsum,   (•(lm[lo^itio^   of,   159 

H 

llainioiiy   of  colors,   317 

Healing   art,   49 

Health,   function    of   gums   ami    teeth   in, 
52 
general,     should     l)e     looked     after     in 
cases    requiring    treatment    for 
loss  of   occlusal   balance,  242 

Hertz,    303 

High-fusing  porcelain,   324 
shrinkage    of,    326 

Hinged   trays   for   taking   impression   of 
cavities,   144 

Hook,   303 

Hormones,    definition    of,   362 

Hot    (l;i.-k.    use   oT,    in    casting,   gives   dis- 
torted   mold,    180 

Hot   water  ;is   a    means   of   warming   wax^ 

i:;i 
Hue  ,,f  .M.jcrs,  :;]  I 


IXDKX 


387 


llutcliiiisdii  's  tectli,  <J0 

Jiuyj^x'iis,  :u);; 

JI  vtlrocliloi'ic    aciti,    '■<'>7 

"hatli,    l.S.-) 
II  vilidlluDi  ic   at-iil,  cl(_•;lIl^:iillg  of  tin-  i-ast- 
iny    in,    JUU 
making    rceciitacle   for,  210 
Jlygienii-   hindnmrks  of  the  teeth,  69 
Jlygroscopic     characteristic     of     invest- 
ments, 165 
Hvpnotics,    use   of,    in   cases  of  attiition, 


Ideal   of  a  task,   46 
Ideal  wax  for  inlay  work,  i;!0 
Immune  areas  of  a  tooth,  69,  70 
Impression  of  the  cavity,  method  of  tak- 
ing,   for    proceduie    by    indirect 
method,    1:59 
of  the  cavity,   method   of   taking,  witli 

eom])onnd  trays,   146 
trays,    339,   344 

wax,   direct   method   of  taking,   131 
Incision,    6U 

teeth  as  organs  of,  52 
Incisor    teeth,    angles    of,    do 

surfaces    of,    65 
Indirect   method   of   making  a   cast   gold 
inlay,   139 
disadvantages  of,   140 
selection   of,   139 
Individual  volition,  48 
Inhibition,    362 

Inhiliitory  functions  of  the  teeth,  60 
Inlay,   cast   gold,   62    (see   Cast   gold   in- 
lay) 
cementation   of,   213,    315 
placing  in  cavity  for  cementation,  213 
polishing    the,    213 
jiorcelain,   (see  Porcelain  inlay) 
restorations,    poorly    executed,    inliilii- 

tory  to  function  of  teeth,  r>o 
wax,  making  and  carving  of,  by  direct 

metliod,    131 
work,  62 

instruments   for   use  in,   73 
metals  for,  182 
wax   suitable   for,   129 
Inlays,  metallic,  ()2 

splinting  loose  teetli  ])y  means  of,  218, 
235 
Inside    of    the   tooth,    77 
Instruments  for  the  inlay  worker,  7.'! 
Instruments    for    making    tlie    wax    inlav, 

137 
Internal    secretion,    oigans    of,    362 
Investment  compound,  158 
Investment  mixer,   168,  170 
Investment   of  tin'   matrix  in  preiiaratimi 
iif   porcelain    insert,  295 


Iridio-platinum  threaded  posts,  sizes   for 
various  teeth,  277 


.lacki't    I  lowns,   objections   to,   293 
Jill'y    cement    tube,    216 
Jiffy   tube,   286 
Johnson,  Dr.,   331 

K 

Kaolin,  323 

Kaplan,  Dr.  I).  M.,  .365 

Kipling,    45 


Labio-distolingual     cavity     in    a    lateral, 

3.39 
Laliio-ncclusal  cavity   in   a  molar,  342 
Labi(j-     or     buccu-occlusal     cavity,    in    a 

molar,  93 
Landmarks  for   occlusal   carving,   152 
hygienic,  69 
of  teeth,   geometric,   65 
Lateral,    cervical    proximal    cavitv    in    a, 
341 
fractured,   restored  by  gold  inlay   ami 

silicate   cement,   275 
labio-disto-lingTial  cavity  in  a,  339 
linguo-mesial  cavity  in,  340 
lower,  fractured  in  a  fall,  279 

restored  by  cast  gold  inlay  and  syn- 
thetic porcelain,  273 
Law   of   refraction,   306 
Le   Crone  casting  machine,   198 
Life,  in  the  abstract,  56 

in   the  concrete,   56 
Light,    absorption    of,    308 
jihenomena   of,   302 
reflection,    305 
refraction,  306 
wave  theory  of,  303 
waves,  frequency  of,  310 
Lily-white,    37 
Lingual  surfaces  of  teeth  to  be  splintecl, 

inlays  for,  231 
Lingiio-mesial  cavity  in  a  lateral,  340 
Loose   teeth,   siilinting   of,   by   means   of 

inlays,  218,  2.35 
Low-fusing  porcelain,  324 

shrinkage  of,  .■J26 
Luminosity    of    color,   311 

M 

Maciiines  f(ir  casting  of  the  molten  jnetal 

into    tiie    mold,    187 
Magnesium,   composition  of,   162 
Making  wax  inlay  by  direct  method,  131 
Malocclusion,  end-to-end,  as  cause  of  at- 
trition,   242 
its   relation   to  prop(M-    function   of  tlie 
teeth,   54 


INDEX 


Malielation  of  teeth,  as  related  to  endo- 
criue  glands,  375,  376 
puberty  in  relation  to,  377 
Margins,    burnishing   of,   after   cementa- 
tion,   217 
carving  of,  in   wax  inlay,   136 
of  the  cavity,  prei:aratiou  of,  76 
Mastication,   60 

teeth  as  organs  of,  52 
Materials   nsod   in   refractory    conipound, 

159 
iratrix,   foil,   for  porcelain   inlay,   333 
for  porcelain  insert,  295 
in  position  upon  a  nio'ar,  141 
making  wax  impression  with   a,   136 
metal,  making  of  porcelain  inlay  with- 
out,  337-357 
]iorcelain,  351 
Measurements  for  normal  face,  249,  255 
Mechanical  factor  in  cavity  preparation, 

71 
Melt,  making  the,  183 
Mental    efforts,    factors   inducing   coordi- 
nate, 24 
IMercurv,  removal  of,  from  amalgam  die, 

150 
Mesio-   and   disto-proximal   cavity,  293 
Mesio-disto-labio-ineisal    deficiency    in    a 
central,  cast  gold  inlay  and  syn- 
thetic  porcelain   insert   for,   291 
Mesio-disto-occlusal   cast  gold   inlay,    12(1 
Mesio-disto-occusal  cavity,  120 
preparation   of,   121,   124 
in  a  bicuspid.  87,  91,  111 
in  a  molar,  99,  343 
Mesio-disto-occluso-palatal     cavity    in     a 

molar,  109 
Mesio-labio-linguo-incisal    deficiency,  cast 
gold   inlay   and   porcelain   insert 
made  for,  289 
restored   by   cast   gold    inlay   and   syn- 
thetic porcelain,  285 
Mesio-occlusal  cavity,  85 
in   a  lower  molar,   343 
tray,  144 
Mesio-occluso-distai  cavity  in  a  bicuspid, 

344 
Metal,  castiiig  of,   umliT  jjicssure,  ]97 
castings  made   under   juessure,    187 
molten,  casting  into  tlie  mold,   178 
removal   of  excess,  213 
Metallic  iidays,  62 
Metals  for  inlay  worker,  182 
gold,  182 
platinum,   182 
Mineral  wax,  composition   of,   128 
Model,  splint  in  jKJsition  on,  247 
Models,  for  study  of  stress  index,  116 
necessary  for  extensive   restoration   of 

occlusal  balance,  240 
study,  236 


Models— Cont  'd. 

study  of,  in  articulatdr,  246 
Molar  crown  divided  into  thirds,  257 
-Niolar,  lower,  mesio-oeelnsal  cavity  in  a, 
343 
presenting    a     cervical     cavity    in    the 

disto-labial  surface,  341 
presenting  a  complex  cavity,  105 
pi-esenting     a     deficiency     of     occlusal 

third,  103 
presenting   a   disto-ocdusal    cavity,   95, 

342,    343 
presenting  a   disto-occ'u^al    cavity    and 

a  disto-buccal  cavity,   97 
presenting  a  labio-oeclusab  cavity,  342 
l^iesenting    a    labio-    or    bucco-occlusal 

cavity,  93 
presenting    a    mesio-disto-occlusal    cav- 
ity, 343 
presenting    a   mesio-disto-occlusal    cav- 
ity and  a  buccal  cavity,  99 
presenting  a  mesio-disto-occ'.uso-lniccal 

cavity,   107 
presenting  a  mesio-disto-occluso-jialatal 

cavity,   109 
reproduction  of,  in  gold,  260 
Molars,  angles  of,  68 

detei-mlnation  of  proximal  contact  l)e- 
tween,  258 
Mold,  casting  the  molten  metal  into  the, 
178' 
drying  out  of  the,  173 
temperature   of,   in   casting   of   molten 
metal,  178 
Molten  metal,  casting  into  the  mold,  178 
casting   of  the,   machines  employed   in 
^187 
Moore,  Tom,  46 
iMiuitli,  ductless  glands  in  relation  to  the, 

;;59 

Myrica  Cei-ifera,  128 
N 
Naso-mental  line,  normal,  249,  255 

restoration  of,  249 
Xewton,   Sir   Isaac,   302 
Xies,  Dr.,  337 
Xitious    oxiih}    combined    \vitli    city    gas 

to   give  nreessary    iieat    units   in 

alloying,   IS.'i 
Xiiiiiial    face,  measurements    I'or,  219,  255 
Xormal    occlusion,    illustrated,    117 
Noyes,  72 
Xynian,    Dr.,    216 

O 

Occluded     mode's    of    ca.'^e    re(|uiiing    res 

toiation,    151 
Occluded    study    moile's,    2.'7 
Occdusal   balance,   delinitiou   ol',   239 

extensixc    i-estora  tion    (jf,    by     means 

of   gold    inlays,   2.'!() 


INDEX 


389. 


Occlusal  balance — ('out  M. 

piclimiiiaiv   jKiiiits  necessary  to  rcs- 

toiatinn    ()!',   240 
rcstoiiition  ol',  view  of  case  sliowiiii^, 

254 
splint  to  restore,  245 
carving',     metliofi     of     seciiiint;'     lainl- 

marks   for,    ]52 
surface   of   wax   inlay,    nietlioil   of   ob- 

taininfi",    IHS 
surfaces,   illustrations   of,   263,   2(34 
view  of  case   sliowiiii;-   attrition,   253 
Occlusion,    normal,    illust  latcil     117 

traumatic,  .'SfiM 
Occluso-disto-lin^ual  jilane,  7!) 
Occluso-nu'sio-liuccal    ])laiie,    79 
On-iiilay,  321 
(Jjieratixe    factor    in    cavitv    pic^iaration, 

71 
Optic   sense,   24 

Oral  conditions  in  cases  of  attrition,  243 
Osseous  system   out   of  harmony,   cause 

of  attrition,  242 
Outside  of  the  tooth,  77 
Ovary  in  relation  to  incisors,  370 
Oxyphosphate,  melting  point  of,  354 
Ozokerino,  129 
Ozokerite,  128 


ParafRne,  composition  of,   128 

Parallel  rays  of  light,  305 

Paralleling-  root   canals   of   teeth   to   be 

splinted,  218 
Parallelodrill,   218,   223 

reaming  out  two  root  canals  with,  224 
Parallelometer,  218,  219 
Parathyroid  bodies,  363 
Partial  splints,   250 

Passive  reciprocal  functions  of  the  teeth, 
58 

cosmetic,  58 

defensive,  58 

developmental,  58 

phonetic,  58 
Pathologic  anatomy,  360 
Phenomena  of  light  and  color,  302 
Phonetic   functions  of  the  teeth,  58 
Piersol,  72 
Pin  vise,  use  of,  in  splinting  teeth  with 

inlays,    229 
Pineal  gland,  363 
Pins,  disadvantage  of,  71 

gauge  wire  for,  79 

preparation  of,   79 
Pituitary  body,  363 
Pituitary  teeth,  375 
I'ituitodontia,  368 
I'ituitotrop,  364 
Planes  of  a  molar  crown,  257 


IManes  jircrerablc  to  ])ins  in  preparation, 

of  cavity,   79  9 
I'lastcr  model  of  teeth,  making  of,  147 
Plaster  of  Paris,   159 
I'latcheck   furnace,   173,   175,    176 
IMatinum,  alloying  with  gold,  183 

combining   weight    of,    182 

foil    for    matrix,    295 

for  inlay  work,  182 

fusing  point,  182 

specific    gravity,    182 

symbol,  182 

Pf)lishing  of  cavity  walls,  125 
of  inlay.  2i:! 
of  wax    inlay,    134 

I'oicclain    and    cast    gold   inlay   for   res- 
toration   of    fractured    lateral, 
279 
and  gold  inlays,  269 
applicable    for    simple    cavities    onlv, 

328 
dental,  composition  of,  323 
fusing  of,  325 
high-fusing,  324,  325 
inlay,  83,  322 

contraindications  to,  322 

foil  matrix  for,  333 

for   conqilex   cavity  in    a   bicuspid, 

113 
indications  for,  322 
making  of,  without  use  of  a  metal 

matrix,  337,  357 
making  Avax  impression  for,  336 
l)reparation  of  cavity  for,  328 
insert  and  cast  gold  inlay  for  mesio- 
labio-linguo-incisal  deficiency  in 
a  central,  289 
and  cast  gold  inlay  in  a  cuspid,  281, 

283 
for  disto-occlusal  cavity  in  a  molar, 

95 
taking  impression  for,  286,  295 
low  fusing,  324 
matrix,  351 

or  silicates,  and  gold  inlays  in  a  frac- 
tured central,  271 
replacing  facial  portions  with  a,  286 

Positional  symptomatic   functions  of  the 

teeth,  60 
Posterior  teeth,  loss  of,  as   a   cause  of 

attrition,    242 
Postnasal  pituitary  state,  376 
Posts,  iridio-platinum,  sizes  for  various 

teeth,  277 
rules  in  connection  with  use  of,  277 
Prehension,  60 

teeth  as  organs  of,  52 
Prehenso-labio  linguo-mesial    deficiency, 

299 


390 


INDEX 


Preliiuinary    stops    bcfoi-e    lici^iniiino-    a 
case    of    exte'iisivi'    iH'stdiat ion. 

Prenatal  pituitary  state,  .")7() 
I'roparation   of   an   M.O.D.   cavity,    121 

of  a  cavity,  (55,  76 

of  e^ivity  for  porcelain  inlay,  328 
Pressure  machines  in  casting,  ]91 

all  metal  castings  made  under,  187 

direction  of  application  of,  for  vari- 
ous cavities,  153 

effect  of,  on  teeth,  54 
Preston,  304 
Price,  Dr.,  350 
Price's  stone  model,  355 
Primary  colors,  312 
Prismatic  colors,  317 
Procreation,  3(54 
Properties    of    -wax    required    for    inlay 

work,   129 
Protector  of  David,  379 
Proximal    contact    bet^veen    molars,    de- 
termination of,  258 
Puberty    in    relation   to   malrelati.on    of 

the  teeth,   377 
Pulp,  extirpation   (if,   27(5 
Pyorrhea,  3<51 

E 

Kadiation,  302 

Kailrnads  in  relation  to  life,  33 

L'ainbow   colors,   317 

Ti'apid    heating,   guard    against,    in    dry- 
ing out  mold,  174 

Reading,  influence   of,   to   coordinate  ac- 
tion,   mental    and    physical,    43 

Eeceptacle    for    hydroflnoric    acid,    mak- 
ing of,  210 

Reciprocal   functions   of   the   teeth,   ac- 
tive, 58 
passive,  58 

Reconstruction     of     molars     ami     bic\is- 
pids,  251 

Record  models,  230,  241,  249 

Reflection  of  light,  304 
angle  of  incidence,  305 
incident   ray,  305 

Refraction  of  light,  law   of,  .'idO 

licfractive  index,  310 

Refractory  compound,  ]58 

investment  of  splint   in,  250 

Removal    of    decay    in     iircjiarat  ion     of 
cavity,  125 

Resistance  pinion,  214 

Restoration,  t-xtensive,  a  case  of,  207 
of  occlusal  bjilance,  case  showing,  254 
of  occlusal   balance  by  means  of  cast 
gold  inlays,  23(5 

Roadi,  Dr.,  instruments  di'\  isrd  by,  344 

Root  canals,  paralb-Jing  of,  2  bS 


Rubber  liowl  for  mixing,  100 
dam  and  clamp,  73 

dam,    use    of,    in    cementation    of    the 
cavity,  215 


S 


Saddles,  gold  for,  ISO 

Sandarac  for  varnishing  model,  152 

Sanford,  314 

Scalers,  73 

Schafer,    72 

Schellenon,  310 

■Schreier,   Dr.,    332 

Seating  the  inlay,  217 

Secondary  colors,  313 

Selection   of   case   presenting  a   cavity, 
64 
of  first  tooth  to  operate  upon  in  ex- 
tensive restorations  of  occlusal 
surfaces,  239 
of  jiroper  wax,  127 

Sense,  auditory,  26 
optic,  24 
tactile,  31 

Separating   tilted   teeth,   330,   331 

Sequence  of  thought,  21 

Seymour  casting  machine,  198 

Shade  of  porcelain,  354 

Shock   to   a  tooth   under   stress   mastica- 
tion, 118 

Shrinkage  of  porcelain,  353 

Silex,  323 

and  water  paste,  295 

Silicate    cement    and    gold    inlay    to    re- 
store fractured  lateral,  275 

Silicate,  replacing  facial  portions  with, 
286 

Silicates  and  cast  gold  inlays,  269 

or  porcelain  and  gold  inlays  in  frac- 
tured central,  271 

Silicon,   composition  of,   100,   101 

Simple  cavity,  defined,  74 

Simple    occlusal    cavity    of    upper    first 
liicuspid,  81 

Sinijilex  casting  macliine,  198 

Slide    for    (;arrying    (-oni]iouii(l,    making 
of,  339-344 

SiKdi's  law  of  refraction,  30(5,  307 

Sodium    bicarbonate    batii,    cleansing   of, 
casting  in,  209 

Solar   sjicct  rum,   30.S 

Soibrig  machine,  199 

S[)atula  for  mixing  ccniciit,  21(i 

for    ])lacing    and     holding    impression 
mal  ri-ial,  ;'>.'!S 

Spccilic  gra\ity  of  gold,   1.S2 
of  jilatinum,  182 

S|)cct  rum.   .'iOS 

Splint,     linislicil,     i-cady     to    be     in.sciicd, 


I.XDKX 


391 


S|)liiit  -Cunt  M. 

for    restorat  iciii    »{'    inilusiil     li:il;iti(-c, 

247 
for  i-cst  or;it  ion   oC  ncchisjil  lialniici'  in 

cases  iif  alt  lit  ion,  24.") 
uso  of,  in  cases  of  attrition  to  rest  me 

occlusal  balance,  245 
vulcanite,   24.S 
Si)lintin<T  anti-rior  teetli.  222 

loose  teeth   l>v   means   of   inlavs,   21S- 
235 
Sprue    wire,    insertion    of,    in    inlay,    L'')4 

use  of,  124 
Rtearine,  211 

Sterilization  of  the  cavity,  215,  21() 
Stokes,  Mn4 

Stress,    a    factor    in    restoring;-    occlusal 
lialance,  2'M 
index,  of  l)icuspi(l,  lower,  .S.'],  S7,  Si),  9 
upj.er,  SI,  S5,  111,  113 
of  central,  lower,  271 
upper,  2S9,  291.  293 
of  cuspid,  lower,  281,  283 

upper,  297,  299 
of   lateral,   lower,   273,   275,   279 

upper,  285 
of  lower  teeth,  115 
of  molar,  lower,  93,  95,  103,  107 

upper,   97,  99,   105,   109 
of  upper  teeth,  114 
Structural    sympotomatic    functions    of 

the  teeth,  (SO 
Study  models,  23() 
Suction  machine  in  castinji",  191 
Sulcus  reproduced  in  wax,  inlay,  77 
Su])plemental  pins,  preparation  of,  79 
SuprarcMial    cajisules,    .".03 
Sure   ('ast    niarliine.    ll'S 
Surfaces  of  Idcuspids.  <i8 
of  cuspids,  07 
of  incisor  teeth,  05 
Surgical   or   opcrati\'e    factor   in    cavity 

preparation,  71 
Susceptible  area  of  a  tooth,  09 
Suspension   ligament,   elasticity  of,   1]8 
Swage,  simple,  198 

Symptomatic  functions  of  the  teeth,  GO 
Synthetic  porcelain  and  ca.st  gold  inlay- 
in  restoration  of  lateral,  285 
and    cast    gold    inlay,    restoration    of 
lower  lateral  by  means  of,  273 
inlay  for  a  complex  cavitA'  in  a  bicus- 
pid, 113 
for    mesio-disto-occlusal    cavity    in 

bicuspid,  89,  91 
for  mesio-ocelusal   cavity   in    bicus- 
pid, 89 
insert   and  cast  gold  inlay  for  mesio- 
disto-labial-incisal  deficiency  in 
a  central,  291 


T 


Tas]<,  ideal  of  a,  4(; 

'I'actile  sense,   31 

Taggart,  1-13 

automatic  buiiier,  174 
automatic  investnii'iit   mixer 
automatic  wax  warmer,  132 
casting  machine,  201,  202 
flask   and  its  crucilde 
tireen   wax.  iiieal   for 


KiS,  170 


former,  204 
inlay  work,  130 


i]ce  of  thought 

0.)0.00(J 


lower.   1 


and 
of   inlays, 


Tait,  304 
Teaching,  \alue  o 

'  in,  21 
Tecliiiic    for    paral 
Teeth,  aiirenal,  375 

as  accessori(\s  of  vocalization,  5: 

as  organs  of  incision.  52 

as  organs  of  mastication,  52 

as  organs   of  prehension,  52 

functions  of,  52 

geometric  landmarks  of,  05 

in    relation    to    organic    disease 
anonuily,  377 

loose,    s])linting   bv 
218-235 

pituitary,  375 

stress  index  for 

stress  index  for  upper.  114 

thymic,  375 

thyroidal,  375 
Temperature  of  mold  for  casting,  178 
Temporomandibular   articulation,   247 
Tertiary  colors,  314 
Test  for  casting  machine,  205 
Thermal   shock,  elimination  of,  in  cavi- 
ty preparation,  120 
Thought,  secpience  of,  21 
Thymic   teeth,  375 
Thymodontia.  .">73. 
Thymo-pituito-adicnal  stress,  370 
Thymotrop,  304 
Thymus,  303 
Thyroadrenal  tooth,  205 
Tliyrodontia,  300 
Thyroid  gland,  303 
Thyroidal  disbalance,  00 
Thyroidal  teeth,  375 
Tilted  teeth,  separating,  330,  331 
Time  in  relation  of  life,  33 
Time  spent  in  mixing  compound,  107 
Tin  foil  burni.shed  on  models,  245 
Tissue  must  be  exercised,  55 
Toilet  of  the  cavity,  125 
Tooth    anatomy,    knowledge    of,    neces- 
sary to  inlay  worker,  152 
Tooth  surfaces  and  angles,  05 
Touch,  .sense  of,  32 
Towlc,  Dr.  Stanly,  357 
Transparent  objects,  color  of,  311 


392 


INDEX 


Traumatic   occlusion,   360 

Traumatic  origin  of  loss  of  occlusal  bal- 
ance, 241 

Tray,  compound-carrying,  338 

Trays  for  taking  impression,  344 

for  use  with  parallelodrill  in  splint- 
ing teeth,  229 
hinged,  for  taking  impressions  of  cav- 
ities, 144 

Trituration,  (30 


U 


Undercuts  in  the  matrix,  355 
Unswaged  matrix,  advantage  of,  357 


V 


\'acuum  machine  for  casting,  191 
a  pressure  machine,  194 

Van  Woert,  Dr.  F.  T.,  330,  332,  337 

Varnishing   of  model,   152 

Vasoauxiliary    functions    of    the    teeth, 
58 

Vasomotor  force  in  relation  to  the  ad- 
renals, 371 

Vibration  in  relation  to  light,  303 

Vocalization,   teeth   as   accessories  of,  52 

A'ulcanite  splint,  making  and  finishing, 
248 

W 

Waller,  Ewan,   .jliii 
Watts,  Marshall,  310 
Wave  theory  of  light,  303 
Wax  bite,  151 
Wax,  bleaching  of,   ]-J:7 
composition  of,  127 


Wax— Cout  'd. 

forcing  into  cavity,  131 
impression   for   porcelain    inlay,   tak- 
ing the,  33C 
for  porcelain  insert,  286,  295 
for  silicate  insert,  taking  of,   277, 

286 
use  of,  in  making  inlays  for  splint- 
ing teeth,  229 
inlay,  chilling  with  cold  water,  135 
for  compound  cavity,  135 
for  mesio-occluso-distal  cavity,  124 
instruments  for  making,  137 
making     and     carving,     by     direct 

method,  131 
making  of,  with  matrix,  136 
polishing  of,  134 
mineral,   128 

mode],  burning  out  the,  173 
ozokerite,  128 
parafitine,    128 

pattern  invested  in  comj^ound,  171 
requirements  for  inlay  work,  129 
selection  of,  127 
splint,  246,  248 
Taggart  green,  ideal  for  inlay  work, 

130 
warmer,  131,  132 
improvised,  134 
white,  128 
Weak  Hands,  37 
Wedgewood  mortar  ,149 
Welden,  Dr.  F.  S.,  357 
White  wax,  composition  of,  128 
Whitmell,  C.  T.,  312 
Wood,  304 


Y 


Young,  303 


1 

COLUMBIA   UNIVERSITY   LIBRARIES 

This  book  is  due  on  the  date  indicated  below,  or  at  the 
expiration  of  a  definite  period  after  the  date  of  borrowing,  as 
provided  by  the  library  rules  or  by  special  arrangement  with 
the  Librarian  in  charge. 

DATE  BORROWED 

DATE  DUE 

DATE  BORROWED 

DATE  DOE 

C28  (358;   lOOM 

Technic  ,iii,(  -,,„ ,,         , 


2002376989 


RKSh9 


j1  iS 


NOV  I  6  1925 


